title: Epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangements in lung cancer with nodular ground-glass opacity.
abstract: BACKGROUND
  Nodular ground-glass opacities (nGGO) are a specific type of lung adenocarcinoma. ALK rearrangements and driver mutations such as EGFR and K-ras are frequently found in all types of lung adenocarcinoma. EGFR mutations play a role in the early carcinogenesis of nGGOs, but the role of ALK rearrangement remains unknown.
  
  
  METHODS
  We studied 217 nGGOs resected from 215 lung cancer patients. Pathology, tumor size, tumor disappearance rate, and the EGFR and ALK markers were analyzed.
  
  
  RESULTS
  All but one of the resected nGGOs were adenocarcinomas. ALK rearrangements and EGFR mutations were found in 6 (2.8%) and 119 (54.8%) cases. The frequency of ALK rearrangement in nGGO was significantly lower than previously reported in adenocarcinoma. Advanced disease stage (p = 0.018) and larger tumor size (p = 0.037) were more frequent in the ALK rearrangement-positive group than in ALK rearrangement-negative patients. nGGOs with ALK rearrangements were associated with significantly higher pathologic stage and larger maximal and solid diameter in comparison to EGFR-mutated lesions.
  
  
  CONCLUSIONS
  ALK rearrangement is rare in lung cancer with nGGOs, but is associated with advanced stage and larger tumor size, suggesting its association with aggressive progression of lung adenocarcinoma. ALK rearrangement may not be important in early pathogenesis of nGGO.
authors.forename: Sung-Jun
authors.initials: SJ
authors.lastname: Ko
authors.forename: Yeon Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Jong Sun
authors.initials: JS
authors.lastname: Park
authors.forename: Young-Jae
authors.initials: YJ
authors.lastname: Cho
authors.forename: Ho Il
authors.initials: HI
authors.lastname: Yoon
authors.forename: Jin-Haeng
authors.initials: JH
authors.lastname: Chung
authors.forename: Tae Jung
authors.initials: TJ
authors.lastname: Kim
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Lee
authors.forename: Kwhanmien
authors.initials: K
authors.lastname: Kim
authors.forename: Sanghoon
authors.initials: S
authors.lastname: Jheon
authors.forename: Hyojin
authors.initials: H
authors.lastname: Kim
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ctlee@snu.ac.kr.
authors.forename: Choon-Taek
authors.initials: CT
authors.lastname: Lee
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D000368:Aged; D000077548:Anaplastic Lymphoma Kinase; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D015321:Gene Rearrangement; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D010641:Phenotype; D011237:Predictive Value of Tests; D011379:Prognosis; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; C512478:EGFR protein, human; D066246:ErbB Receptors; D020794:Receptor Protein-Tyrosine Kinases