Malignant Pleural Effusion Supernatants Are Substitutes for Metastatic Pleural Tumor Tissues in EGFR Mutation Test in Patients with Advanced Lung Adenocarcinoma

Abstract

BackgroundThough the possibility of using malignant pleural effusions (MPEs) as alternatives for metastatic pleural tumor tissues (MPTTs) in epidermal growth factor receptor (EGFR) mutation test has been examined, due to the lack of studies comparing the results in matching MPEs and MPTTs, the clinical value of MPEs for advanced adenocarcinoma patients with pleural effusions is not confirmed.MethodsEGFR mutation statuses in matching MPTTs, MPE supernatants and cell blocks, of 41 patients with advanced lung adenocarcinoma as diagnosed by thoracoscopy were analyzed using amplification refractory mutation system (ARMS).ResultsEGFR mutations were detected in 46.3% (19/41) of MPTTs, 43.9% (18/41) of MPE supernatants and 56.3% (18/32) of MPE cell blocks by ARMS analysis. Generally, the same EGFR statuses were identified in both MPTTs and matching MPE cell blocks of 81.3% patients (26/32), whereas MPTTs and matching MPE supernatants of 87.8% (36/41) patients shared the same EGFR status. Compared with EGFR mutation detection in MPTTs, the sensitivity of EGFR mutation detection in MPE-cell blocks was 87.5% (14/16), specificity was 75.0% (12/16), while the sensitivity of EGFR mutation detection in MPE-supernatants was 84.2% (16/19), specificity was 90.9% (20/22).ConclusionsThe high concordance of EGFR mutation statuses between MPEs and MPTTs in lung adenocarcinoma patients with pleural metastasis as determined by ARMS analysis suggests that MPEs, particularly MPE supernatants, may be substitutes for MPTTs in EGFR mutation test.

Malignant pleural effusion supernatant is an alternative liquid biopsy specimen for comprehensive mutational profiling

“…Because excessive MPE needs to be drained regularly to maintain patient breathing, it is a convenient alternative liquid biopsy specimen. Over the years, multiple studies have shown that MPE can be used as a liquid biopsy media for mutation detection by PCR and NGS however, most of these studies used MPE cell pellets, with only a few evaluating the suitability of MPE supernatant to detect mutation, often from a single gene perspective. Liu et al .…”

A Combined test using both cell sediment and supernatant cell‐free DNA in pleural effusion shows increased sensitivity in detecting activating EGFR mutation in lung cancer patients

“…Malignant pleural effusions can be observed in patients with various types of neoplasm, but most frequently in lung adenocarcinoma . Although DNA extraction from cancer cells is the gold‐standard in EGFR mutation analysis, some investigators have analysed the relationship between EGFR mutation rate in pleural effusion supernatant and patient response to gefitinib . Some previous reports used malignant pleural effusion supernatant samples for EGFR mutation analysis, and Liu et al reported that malignant supernatants may be substitutes for metastatic pleural tumour tissues in EGFR mutation testing.…”

Epidermal growth factor receptor mutation status in cell‐free DNA supernatant of bronchial washings and brushings

“…Liu et al reported that malignant pleural effusion supernatants are substitutes for metastatic pleural tumor tissues in EGFR mutation testing. Bronchial brushing samples can be obtained by relatively noninvasive methods, and they can be obtained repeatedly.…”