title: Associations between the IASLC/ATS/ERS lung adenocarcinoma classification and EGFR and KRAS mutations.
abstract: We sought to investigate the frequency of mutations in epidermal growth factor receptor (EGFR) and Kirsten-RAS (KRAS) by each pathological subtype for patients with resected pulmonary adenocarcinoma as defined by the IASLC/ATS/ERS classification. Histological examination determined the predominant subtype according to the IASLC/ATS/ERS classification. EGFR and KRAS mutations were determined by high-resolution melting and Sanger sequencing. Clinical data were collected from medical records and clinicians. The 178 consecutive patients consisted of 48% males, median age 68 years (range 20-87) and smoking history 78%. The tumour stage was I in 62%, II in 18% and III in 20%. The mutation rates were: EGFR 30%; KRAS 28%. The rate of EGFR mutations in the acinar predominant reference group (n=76), was 37%. The solid predominant subtype showed significantly fewer EGFR mutations [3/33 (9%), odds ratio 0.17 (0.05-0.61), p=0.007]. No differences in mutation rate were observed in other subtypes. No association was found between KRAS mutations and predominant histological subtype. Advanced stage and solid predominant subtype were negative prognostic factors. EGFR mutations can be present in adenocarcinoma of any predominant subtype, however rarely in solid predominant tumours. No association was found between KRAS mutation and the predominant histological subtype.
authors.affiliation: St Vincent's Hospital, Melbourne, Australia; University of Melbourne, Australia. Electronic address: drclayoncologist@gmail.com.
authors.forename: T D
authors.initials: TD
authors.lastname: Clay
authors.affiliation: St Vincent's Hospital, Melbourne, Australia; University of Melbourne, Australia.
authors.forename: P A
authors.initials: PA
authors.lastname: Russell
authors.affiliation: University of Melbourne, Australia; Translational Genomics and Epigenetics Laboratory, Olivia Newton John Cancer Research Institute, Heidelberg Australia; School of Cancer Medicine, La Trobe University, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Do
authors.affiliation: University of Melbourne, Australia.
authors.forename: V
authors.initials: V
authors.lastname: Sundararajan
authors.affiliation: St Vincent's Hospital, Melbourne, Australia; University of Melbourne, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Conron
authors.affiliation: St Vincent's Hospital, Melbourne, Australia; University of Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Vic, Australia.
authors.forename: G M
authors.initials: GM
authors.lastname: Wright
authors.affiliation: University of Melbourne, Australia; Translational Genomics and Epigenetics Laboratory, Olivia Newton John Cancer Research Institute, Heidelberg Australia; School of Cancer Medicine, La Trobe University, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Dobrovic
authors.affiliation: St Vincent's Hospital, Melbourne, Australia; University of Melbourne, Australia.
authors.forename: M M
authors.initials: MM
authors.lastname: Moore
authors.affiliation: St Vincent's Hospital, Melbourne, Australia; University of Melbourne, Australia.
authors.forename: S A
authors.initials: SA
authors.lastname: McLachlan
mesh_terms: D000230:Adenocarcinoma / Q000145:classification* / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000235:genetics; D001315:Australia; D015331:Cohort Studies; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000145:classification* / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics*; D012955:Societies, Medical; D016019:Survival Analysis; D044465:White People / Q000235:genetics; D055815:Young Adult
chemical_list: C117307:KRAS protein, human; C512478:EGFR protein, human; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras)
keywords: EGFR; IASLC/ATS/ERS classification; KRAS; Lung adenocarcinoma