Value of serum tumor markers for predicting EGFR mutations and positive ALK expression in 1089 Chinese non-small-cell lung cancer patients: A retrospective analysis

Wang, Sufei; Ma, Pei; Ma, Guanzhou; Lv, Zhi; Wu, Feng; Guo, Mengfei; Li, Yumei; Tan, Qi; Song, Siwei; Zhou, Enbo; Wang, Geng; Duan, Yanran; Yan, Li; Jin, Yang

doi:10.1016/j.ejca.2019.10.005

Cited by 38 publications

(57 citation statements)

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“…The previously reported prevalence of ALK mutation was 3-7% [19][20][21][22]. In this study, ALK mutation was found positive in 5.7% cases through ARMS-PCR and in 4.2% cases through IHC(D5F3), which was slightly lower than the mutational rate of 6.1% detected by Wang through IHC(D5F3) [23]. The overall frequency of ALK mutation was 4.5% in this study, which was almost consistent with previous reports.…”

Section: Discussionsupporting

confidence: 91%

Analysis of lung biopsies using the 2015 WHO criteria and detection of sensitizing mutations——a single-institution experience of 5032 cases

et al. 2020

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Background: A specialized classification for small biopsies was added to the 2015 WHO classification of lung tumors. The purpose of this study is to explore and summarize the experience of applying the newly proposed classifications and criteria to clinical practice. Methods: We used the 2015 WHO criteria to sort out 5032 small lung biopsies from a group of Chinese patients, and demonstrated their clinicopathological features, mutational status and the relationship between these factors. Results: The most common diagnosis was primary lung carcinoma (3130, 62.2%), among which adenocarcinoma (1421, 28.2%) was the most frequent histological type. The mutational assays using ARMS-PCR technology demonstrated that EGFR was positive in 56.1% cases(499/889, from adenocarcinoma and NSCC, favor adenocarcinoma), ALK in 5.7% cases(12/211, from NSCC, which comprised all the primary lung carcinomas except small cell carcinomas), and ROS1 in 0.9% cases(2/211, from NSCC). Another 898 NSCC specimens went through an immunohistochemical (IHC) examination for ALK (D5F3) and 38 of them were positive (4.2%). The overall mutation rate of ALK was 4.5% (50/1119). There was no significant difference between ARMS-PCR and immunohistochemistry in the positive rate of ALK mutation detection (P = 0.359). EGFR mutations (P = 0.02) and ALK mutations (P < 0.001) both decreased with an increasing patient age. Furthermore, the amount of EGFR mutations was higher in adenocarcinoma (64.1% vs 34.1%, P < 0.001) than in NSCC, favor adenocarcinoma. In contrast, ALK mutations were more common in NSCC, favor adenocarcinoma (4.2% vs 8.4%, P = 0.021). Conclusions: This single-center study exhibited a large subset of small lung biopsies from a Chinese institution and demonstrated that applying the 2015 WHO classification for small lung biopsies can help predict the mutational status of primary lung carcinomas.

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Section: Discussionsupporting

confidence: 91%

Analysis of lung biopsies using the 2015 WHO criteria and detection of sensitizing mutations——a single-institution experience of 5032 cases

et al. 2020

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“…In most recent retrospective clinical practice studies, the number of patients evaluated was around 100 (14)(15)(16)(17)(18)(19)(20). Several studies on tumor markers in ALK-rearranged NSCLC patients have been reported (21)(22)(23)(24). Many of these reports examined whether tumor markers could be useful for diagnosis (21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies on tumor markers in ALK-rearranged NSCLC patients have been reported (21)(22)(23)(24). Many of these reports examined whether tumor markers could be useful for diagnosis (21)(22)(23)(24). Also, the number of ALK-rearranged NSCLC patients studied was low in many reports, up to 54 patients (21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

“…Many of these reports examined whether tumor markers could be useful for diagnosis (21)(22)(23)(24). Also, the number of ALK-rearranged NSCLC patients studied was low in many reports, up to 54 patients (21)(22)(23)(24). In all NSCLC patients without considering gene mutations, there have been reports examining the significance of CEA and CYFRA in distant metastasis and prognosis.…”

Section: Discussionmentioning

confidence: 99%

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Serum CEA and CYFRA Levels in ALK-rearranged NSCLC Patients: Correlation With Distant Metastasis

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Endo

Yanai

et al. 2020

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Aim: To clarify the correlation between serum levels of carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA) and metastasis and survival in anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC) patients. Patients and Methods: CEA and CYFRA levels in 131 ALK-rearranged NSCLC patients were determined using fluorescence in situ hybridization (FISH), real time-reverse transcription polymerase chain reaction, and immunohistochemistry, using biopsy specimens, cytology specimens, and plasma specimens. Cutoff value of each marker was determined as 10 ng/ml. Results: In logistic regression analysis, higher levels of both markers had a positive relationship with bone metastases, and higher levels of CYFRA was relevant to liver metastases, and multiple-organ metastases. However, these markers were not proven to be poor prognostic factors in Cox's proportional model analysis. Conclusion: Elevated serum CEA and CYFRA levels seem to provide useful clinical information about presence of bone and liver metastasis and multiple-organ metastases, although they were not a powerful indicator of prognosis. These two markers may suggest the extension of metastasis and would be helpful in considering treatment options. Carcinoembryonic antigen (CEA) has been widely used in clinical practice as a serum tumor marker for non-small cell lung cancer (NSCLC) patients (1). Cytokeratin 19 fragment (CYFRA) is also one of the representative serum tumor markers used for detection of NSCLC patients in clinical practice (1). CEA is a glycoprotein and CYFRA is a soluble 2095 This article is freely accessible online.

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“…Because of the rarity of ALK-rearranged NSCLC, it is important to collect and evaluate data in clinical practice in addition to the results of clinical trials to evaluate its significance. ALK rearranged gene mutation is an oncogenic driver of NSCLC and commonly associated with younger age (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Although under a small number, however, elderly ALKrearranged NSCLC patients also have been reported (17)(18)(19).…”

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confidence: 99%

Clinicopathological Features in Elderly ALK-rearranged Non-small Cell Lung Cancer Patients

Miyazaki¹,

Sato²,

Kodama³

et al. 2020

In Vivo

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Aim: To clarify the clinicopathological features in elderly anaplastic lymphoma kinase (ALK) rearranged non-small cell lung cancer (NSCLC) patients. Patients and Methods: A retrospective study was performed in 129 ALK rearranged NSCLC patients diagnosed between April 2008 and March 2019 in fifteen Institutions of the Ibaraki prefecture, Japan. Results: Median age of patients was 63 years. In 59 patients aged 65 and older, the proportions of patients with advanced stage and those treated with ALKtyrosine kinase inhibitor (TKI) were lower than those younger than 65 years. There was no difference in overall survival (OS) between the two age groups. Among the elderly patients, no difference was observed in OS between the patients aged 65-69 and those aged 70 and older. In 89 patients treated with TKI, no significant differences were observed in the progression-free survival of TKIs and OS between patients aged 65 and older and those younger than 65, respectively. Conclusion: Evaluation of ALK gene status and TKI treatment are desirable even for elderly patients. Advances in molecular biology have led to discovery of specific driver genes in certain cancer types and therefore to development of specific therapeutics (1, 2). This new trend is evident in the clinical practice of NSCLC patients. Mutations in the anaplastic lymphoma kinase (ALK) fusion gene is one such driver gene. Long-term survival can be expected in ALKrearranged NSCLC patients, but its frequency is very rare (1, 2001 This article is freely accessible online.

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Value of serum tumor markers for predicting EGFR mutations and positive ALK expression in 1089 Chinese non-small-cell lung cancer patients: A retrospective analysis

Cited by 38 publications

References 38 publications

Analysis of lung biopsies using the 2015 WHO criteria and detection of sensitizing mutations——a single-institution experience of 5032 cases

Analysis of lung biopsies using the 2015 WHO criteria and detection of sensitizing mutations——a single-institution experience of 5032 cases

Serum CEA and CYFRA Levels in ALK-rearranged NSCLC Patients: Correlation With Distant Metastasis

Clinicopathological Features in Elderly ALK-rearranged Non-small Cell Lung Cancer Patients

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