Open Access
Detection of EGFR and K-ras mutations for diagnosis of multiple lung adenocarcinomas
Teruo Iwata1,Kenji Sugio1,Hidetaka Uramoto1,Sohsuke Yamada1,Takamitsu Onitsuka1,Naohiro Nose1,Kenji Ono1,Mitsuhiro Takenoyama1,Tsunehiro Oyama1,Takeshi Hanagiri1,Kosei Yasumoto1
Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
DOI: 10.2741/3891 Volume 16 Issue 8, pp.2961-2969
Published: 01 June 2011
(This article belongs to the Special Issue Gene regulation and structure-function of P450 Cold stress response)

The incidence of multiple primary lung adenocarcinoma (MPLA) is increasing, and it is important to distinguish MPLA from intrapulmonary metastasis (IPM) in order to determine the therapeutic strategy. However, there is no reliable method to differentiate between the two. The purpose of this study was to distinguish MPLA from IPM based on the gene status of EGFR and K-ras and the morphological Noguchi classification system. Sixty-eight tumors from 34 cases of clinical MPLA were evaluated. Of them, 11 cases (32.4%) were diagnosed as biological MPLA (bMPLA) by EGFR/K-ras mutation analyses, and 12 cases (35.3%) by morphological analysis. In all, 23 of the 34 cases (67.6%) were diagnosed as bMPLA. The remaining 11 cases were diagnosed as biological IPM (bIPM). The 5-year survival rates of bMPLA and bIPM were 90.9% and 63.6%, respectively (p=0.04). These findings suggest that the combination method including gene mutation and morphological analysis can guide treatment decisions and that there is a need for systemic chemotherapy, and surveillance monitoring.

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Teruo Iwata, Kenji Sugio, Hidetaka Uramoto, Sohsuke Yamada, Takamitsu Onitsuka, Naohiro Nose, Kenji Ono, Mitsuhiro Takenoyama, Tsunehiro Oyama, Takeshi Hanagiri, Kosei Yasumoto. Detection of EGFR and K-ras mutations for diagnosis of multiple lung adenocarcinomas. Frontiers in Bioscience-Landmark. 2011. 16(8); 2961-2969.