title: EGFR mutation and lobar location of lung adenocarcinoma.
abstract: The objective of this study was to investigate the associations among lung cancer location, and epidermal growth factor receptor (EGFR) mutation status. Treatment-naive, pathologically confirmed lung adenocarcinomas with tumor specimens available for genetic analysis were included from 2011 through 2014. Overall, 1771 patients with lung adenocarcinoma were included for analysis, after excluding those with carcinoma not otherwise specified, or synchronous multiple primary lung cancers. The median age was 64 years, and the female:male and never smoker:ever smoker ratios were 930:855 (52:48%) and 1167:604 (65:35%), respectively. The EGFR mutation rate was 56%. Among patients, 1093 (62%) had primary tumors in the upper lobes. Compared with the characteristics of the EGFR wild-type, tumors with EGFR activating mutations were more common in women (P < 0.001), never smokers (P < 0.001), and in the upper lobes (P = 0.004). Among EGFR activating mutations, compared with the EGFR exon 19 deletion, L858R mutation were more common in women (P = 0.002), never smokers (P = 0.038), and the upper lobes P < 0.0005). The present study is the first to address that different pulmonary lobar locations might harbor different EGFR mutation subtypes. We demonstrated that adenocarcinomas with L858R mutation, rather than exon 19 deletion or wild-type EGFR gene, prefer to locate over the upper lungs. This phenomenon was more significant in females and never-smokers, implying the result of complex interactions between genetic susceptibility and environmental factors. Therefore, EGFR L858R mutation and exon 19 deletion may not be identical disease entity from the point of carcinogenesis.
authors.affiliation: Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.|Division of Critical Care Medicine and.
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Tseng
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Kun-Chieh
authors.initials: KC
authors.lastname: Chen
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Kuo-Hsuan
authors.initials: KH
authors.lastname: Hsu
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Jeng-Sen
authors.initials: JS
authors.lastname: Tseng
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan.
authors.forename: Chao-Chi
authors.initials: CC
authors.lastname: Ho
authors.affiliation: Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.|Department of Respiratory Therapy, China Medical University, Taichung, Taiwan.
authors.forename: Te-Chun
authors.initials: TC
authors.lastname: Hsia
authors.affiliation: Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan.|Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Kang-Yi
authors.initials: KY
authors.lastname: Su
authors.affiliation: Divisions of Medical Oncology and Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Ming-Fang
authors.initials: MF
authors.lastname: Wu
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Taichung Tzu-Chi Hospital, Taichung, Taiwan.|School of Post-baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Kuo-Liang
authors.initials: KL
authors.lastname: Chiu
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Taichung Tzu-Chi Hospital , Taichung , Taiwan.
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Liu
authors.affiliation: School of Medicine, Chung Shan Medical University, Taichung, Taiwan.|Division of Pulmonary Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Tzu-Chin
authors.initials: TC
authors.lastname: Wu
authors.affiliation: Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.|Division of Pulmonary and Critical Care Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Hung-Jen
authors.initials: HJ
authors.lastname: Chen
authors.affiliation: Institute of Statistical Science, Academia Sinica , Taipei , Taiwan.
authors.forename: Hsuan-Yu
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Institute of Statistical Science, Academia Sinica , Taipei , Taiwan.
authors.forename: Chi-Sheng
authors.initials: CS
authors.lastname: Chang
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chung-Ping
authors.initials: CP
authors.lastname: Hsu
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital , Taichung , Taiwan.
authors.forename: Jiun-Yi
authors.initials: JY
authors.lastname: Hsia
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital , Taichung , Taiwan.
authors.forename: Cheng-Yen
authors.initials: CY
authors.lastname: Chuang
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital , Taichung , Taiwan.
authors.forename: Chin-Hung
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Institute of Biomedical Sciences, National Chung Hsing University , Taichung , Taiwan.
authors.forename: Jeremy J W
authors.initials: JJW
authors.lastname: Chen
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan.
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Chen
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan.
authors.forename: Wei-Yu
authors.initials: WY
authors.lastname: Liao
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.|Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Jin-Yuan
authors.initials: JY
authors.lastname: Shih
authors.affiliation: Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan.|Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.|NTU Center for Genomic Medicine.|Department of Pathology and Graduate Institute of Pathology and.|Center for Optoelectronic Biomedicine, College of Medicine, National Taiwan University, Taipei, Taiwan and.
authors.forename: Sung-Liang
authors.initials: SL
authors.lastname: Yu
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan.
authors.forename: Chong-Jen
authors.initials: CJ
authors.lastname: Yu
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan.
authors.forename: Pan-Chyr
authors.initials: PC
authors.lastname: Yang
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tsung-Ying
authors.initials: TY
authors.lastname: Yang
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Gee-Chen
authors.initials: GC
authors.lastname: Chang
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000473:pathology*; D000368:Aged; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
chemical_list: C512478:EGFR protein, human; D066246:ErbB Receptors