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2017 ; 8
(47
): 82244-82255
Nephropedia Template TP
gab.com Text
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English Wikipedia
Pathologic subtype-defined prognosis is dependent on both tumor stage and status
of oncogenic driver mutations in lung adenocarcinoma
#MMPMID29137260
Dong Y
; Li Y
; Jin B
; Zhang J
; Shao J
; Peng H
; Tu S
; Han B
Oncotarget
2017[Oct]; 8
(47
): 82244-82255
PMID29137260
show ga
Previous studies have shown that the prognosis of lung adenocarcinoma is
associated with pathological characterization. In this study, we investigated
whether pathology-based prognosis was further influenced by both tumor stage and
oncogenic driver mutations. To this end, we recruited a cohort of 465 lung
adenocarcinoma patients in China. These patients were classified into 6
pathology-defined subtypes i.e., lepidic-predominant adenocarcinoma (LPA),
acinar-predominant adenocarcinoma (APA), papillary-predominant adenocarcinoma
(PPA), micropapillary-predominant adenocarcinoma (MPA), solid-predominant
adenocarcinoma (SPA), and invasive mucinous adenocarcinoma (IMA). Oncogenic
mutations in EGFR, KRAS, ALK, RET, and BRAF genes were determined using
fluorescent real-time RT-PCR. The associations of pathogenic subtype or oncogenic
mutation with clinical characteristics were analyzed using Fisher's exact tests.
The interactive effects on overall survival (OS) by pathologic subtype, oncogenic
mutations, and tumor stage were also determined. We have found that pathogenic
subtype of lung adenocarcinoma correlated with smoking habit and tumor cell
differentiation. These pathology-defined subtypes can be regrouped into 3
pathology-based prognostic groups: PPG1 (LPA), PPG2 (IMA+APA+PPA), and PPG3
(MPA+SPA) with a favorable, intermediate, and poor OS, respectively. We further
demonstrated that this pathology-determined OS can be affected by both tumor
stage and status of oncogenic mutations in EGFR, KRAS, ALK, RET, and BRAF genes.
Interestingly, the presence of genetic mutations related to ALK, RET and BRAF had
an opposite effect on OS between PPG2 (worsen) and PPG3 (improved) patients,
reversing the prognostic favorability for patients within these two groups. In
conclusion, prognosis of lung adenocarcinoma was defined interactively by
pathologic subtype, tumor stage and oncogenic mutation.