Added Value of 50-Gene Panel Sequencing to Distinguish Multiple Primary Lung Cancers from Pulmonary Metastases
| Autor: | Paul Roepman, Gerarda J.M. Herder, Tobias Sprong, Daniëlle A M Heideman, K. C. Scheidel, Kees A. Seldenrijk, J. Alain Kummer, Alexandra ten Heuvel |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Lung business.industry Hazard ratio medicine.disease Tp53 mutation Pathology and Forensic Medicine 03 medical and health sciences 030104 developmental biology 0302 clinical medicine medicine.anatomical_structure Text mining 030220 oncology & carcinogenesis Internal medicine Gene panel medicine Overall survival Molecular Medicine Immunohistochemistry Lung cancer business |
| Zdroj: | The Journal of Molecular Diagnostics. 20:436-445 |
| ISSN: | 1525-1578 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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