title: Detection of EGFR and K-ras mutations for diagnosis of multiple lung adenocarcinomas.
abstract: The incidence of multiple primary lung adenocarcinoma (MPLA) is increasing, and it is important to distinguish MPLA from intrapulmonary metastasis (IPM) in order to determine the therapeutic strategy. However, there is no reliable method to differentiate between the two. The purpose of this study was to distinguish MPLA from IPM based on the gene status of EGFR and K-ras and the morphological Noguchi classification system. Sixty-eight tumors from 34 cases of clinical MPLA were evaluated. Of them, 11 cases (32.4%) were diagnosed as biological MPLA (bMPLA) by EGFR/K-ras mutation analyses, and 12 cases (35.3%) by morphological analysis. In all, 23 of the 34 cases (67.6%) were diagnosed as bMPLA. The remaining 11 cases were diagnosed as biological IPM (bIPM). The 5-year survival rates of bMPLA and bIPM were 90.9% and 63.6%, respectively (p=0.04). These findings suggest that the combination method including gene mutation and morphological analysis can guide treatment decisions and that there is a need for systemic chemotherapy, and surveillance monitoring.
authors.affiliation: Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Teruo
authors.initials: T
authors.lastname: Iwata
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugio
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Uramoto
authors.forename: Sohsuke
authors.initials: S
authors.lastname: Yamada
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Onitsuka
authors.forename: Naohiro
authors.initials: N
authors.lastname: Nose
authors.forename: Kenji
authors.initials: K
authors.lastname: Ono
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takenoyama
authors.forename: Tsunehiro
authors.initials: T
authors.lastname: Oyama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hanagiri
authors.forename: Kosei
authors.initials: K
authors.lastname: Yasumoto
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics* / Q000556:secondary; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D018773:Genes, erbB-1; D011905:Genes, ras; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000235:genetics*
chemical_list: C512478:EGFR protein, human; D066246:ErbB Receptors