EGFR 突变型和 EGFR 野生型肺腺癌（乳头状为主）的临床病理学差异。
Clinicopathological differences between EGFR mutated and EGFR wild-type lung adenocarcinoma with papillary predominant pattern.
发表日期：2024 May 23
作者：
Eisuke Goto, Tetsuro Taki, Kotaro Nomura, Yuko Miyakami, Tomohiro Miyoshi, Kenta Tane, Joji Samejima, Keiju Aokage, Michiko Nagamine, Shingo Sakashita, Naoya Sakamoto, Motohiro Kojima, Kenji Suzuki, Masahiro Tsuboi, Genichiro Ishii
来源：
LUNG CANCER
摘要：
我们的目的是揭示表皮生长因子受体 (EGFR) 突变和野生型 (WT) 肺腺癌 (LUAD) 之间的临床病理差异，重点关注主要亚型。本研究包括连续阶段的 352 名 EGFR 突变患者和 370 名 WT 患者I LUAD按主要亚型进行分类，并分析其临床病理特征和预后。使用癌症基因组图谱计划 (TCGA) 队列，我们分析了 EGFR 突变组和 WT 组之间基因表达的差异。此外，我们对 46 名 EGFR 突变患者和 47 名 WT 连续 I 期乳头状为主腺癌 (PPA) 患者进行了免疫组织化学评估。与 WT [n = 115] 的 PPA 患者相比，EGFR 突变患者 [n = 99] 表现出更小侵入大小（p = 0.03）和血管侵入频率较低（p < 0.01）。然而，与 WT 相比，EGFR 突变 PPA 的 5 年无复发生存 (RFS) 率明显较差（70.6% 对比 83.3%，p = 0.03）。相反，在其他主要亚型中没有观察到显着差异。在 TCGA 队列中，与 WT 相比，具有 EGFR 突变的 PPA 往往表现出更高的半乳糖凝集素 3 表达，这与肿瘤转移和失巢凋亡抵抗相关（p = 0.06）。免疫组织化学评估显示，EGFR 突变的 PPA 中 Galectin-3 的表达显着高于 WT（p < 0.01）。EGFR 突变的 PPA 的预后较 WT 较差，且 Galectin-3 的表达较 WT 低。在 EGFR 突变的 PPA 中高度表达。版权所有 © 2024 Elsevier B.V. 保留所有权利。
We aimed to reveal the clinicopathological differences between epidermal growth factor receptor (EGFR)-mutated and wild-type (WT) lung adenocarcinoma (LUAD) focusing on the predominant subtype.This study included 352 with EGFR mutation and 370 with WT patients in consecutive stage I LUAD classified by the predominant subtype, and their clinicopathological characteristics and prognosis were analyzed. Using the Cancer Genome Atlas Program (TCGA) cohort, we analyzed differences in gene expression between EGFR mutation and WT groups. Furthermore, we performed immunohistochemical evaluations for 46 with EGFR mutation and 47 with WT patients in consecutive stage I papillary predominant adenocarcinoma (PPA).Compared to the PPA with WT [n = 115], those with EGFR mutation [n = 99] exhibited smaller invasive size (p = 0.03) and less frequent vessel invasion (p < 0.01). However, PPA with EGFR mutation showed significantly worse 5-ys recurrence-free survival (RFS) rates compared to those with WT (70.6 % versus 83.3 %, p = 0.03). Contrarily, no significant differences were observed in other predominant subtypes. In the TCGA cohort, PPA with EGFR mutation tended to show higher expression of galectin-3, which is associated with tumor metastasis and resistance to anoikis, compared to those with WT (p = 0.06). Immunohistochemical evaluation revealed that galectin-3 expression was significantly higher in PPA with EGFR mutation than in those with WT (p < 0.01).The prognosis of PPA with EGFR mutation proved to be less favorable compared to that with WT, and galectin-3 is highly expressed in EGFR-mutated PPA.Copyright © 2024 Elsevier B.V. All rights reserved.