Added Value of 50-Gene Panel Sequencing to Distinguish Multiple Primary Lung Cancers from Pulmonary Metastases: A Systematic Investigation.

Autor:	Roepman P; Pathology-DNA, St. Antonius Hospital, Nieuwegein, the Netherlands. Electronic address: moleculair@pathologie-dna.nl., Ten Heuvel A; Department of Pulmonary Disease, St. Antonius Hospital, Nieuwegein., Scheidel KC; Pathology-DNA, St. Antonius Hospital, Nieuwegein, the Netherlands., Sprong T; Pathology-DNA, St. Antonius Hospital, Nieuwegein, the Netherlands., Heideman DAM; Department of Pathology, VU Medical Center, Amsterdam, the Netherlands., Seldenrijk KA; Pathology-DNA, St. Antonius Hospital, Nieuwegein, the Netherlands., Herder GJM; Department of Pulmonary Disease, St. Antonius Hospital, Nieuwegein., Kummer JA; Pathology-DNA, St. Antonius Hospital, Nieuwegein, the Netherlands.
Jazyk:	angličtina
Zdroj:	The Journal of molecular diagnostics : JMD [J Mol Diagn] 2018 Jul; Vol. 20 (4), pp. 436-445. Date of Electronic Publication: 2018 Apr 03.
DOI:	10.1016/j.jmoldx.2018.02.007
Abstrakt:	Differentiation between multiple primary lung cancers and pulmonary metastases (PM) has important implications in staging, prognosis, and treatment strategies. Clinical and immunohistopathologic criteria have been standardized; however, a substantial number of cases remain difficult to classify. Using next-generation sequencing, it is now possible to improve the classification of multiple lung cancer lesions. This study systematically investigated the value of routine morphologic and IHC characteristics, p53 protein expression, TP53 mutation analysis, and 50-gene panel sequencing (GPS) in 111 lesions from 50 patients with multiple lung lesions. Based on immunohistopathologic criteria, 32 paired lesions were classified as multiple primary lung cancer (MPLC) and 21 as PM. TP53 mutation analysis indicated MPLC in 23 and PM in 6 pairs, but in the majority of cases (n = 28, 49%) no mutation was observed and no conclusion could be drawn. In contrast, only 2 pairs were not conclusive using GPS. In a significant number of matching tumor samples (n = 19, 39%), sequencing results were contradictory to the initial immunohistopathology diagnosis. No separation in overall survival for classifications based on immunohistopathology was observed, while a clear but nonsignificant trend was observed concerning survival in MPLC patients (hazard ratio = 3.98) using 50-gene GPS. In about one-third of the patients, GPS provided additional information to improve the differentiation between MPLC and PM. (Copyright © 2018 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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