Chronic Obstructive Pulmonary Disease Is Not Associated with KRAS Mutations in Non-Small Cell Lung Cancer

PLoS One. 2016 Mar 23;11(3):e0152317. doi: 10.1371/journal.pone.0152317. eCollection 2016.

Abstract

Mutations in epithelial growth factor receptor (EGFR), as well as in the EGFR downstream target KRAS are frequently observed in non-small cell lung cancer (NSCLC). Chronic obstructive pulmonary disease (COPD), an independent risk factor for developing NSCLC, is associated with an increased activation of EGFR. In this study we determined presence of EGFR and KRAS hotspot mutations in 325 consecutive NSCLC patients subjected to EGFR and KRAS mutation analysis in the diagnostic setting and for whom the pulmonary function has been determined at time of NSCLC diagnosis. Information about age at diagnosis, sex, smoking status, forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) was collected. Chronic obstructive pulmonary disease(COPD) was defined according to 2013 GOLD criteria. Chi-Square, student t-test and multivariate logistic regression were used to analyze the data. A total of 325 NSCLC patients were included, 193 with COPD and 132 without COPD. COPD was not associated with presence of KRAS hotspot mutations, while EGFR mutations were significantly higher in non-COPD NSCLC patients. Both female gender (HR 2.61; 95% CI: 1.56-4.39; p<0.001) and smoking (HR 4.10; 95% CI: 1.14-14.79; p = 0.03) were associated with KRAS mutational status. In contrast, only smoking (HR 0.11; 95% CI: 0.04-0.32; p<0.001) was inversely associated with EGFR mutational status. Smoking related G>T and G>C transversions were significantly more frequent in females (86.2%) than in males (61.5%) (p = 0.008). The exon 19del mutation was more frequent in non-smokers (90%) compared to current or past smokers (36.8%). In conclusion, KRAS mutations are more common in females and smokers, but are not associated with COPD-status in NSCLC patients. EGFR mutations are more common in non-smoking NSCLC patients.

MeSH terms

  • Aged
  • Carcinoma, Non-Small-Cell Lung / genetics*
  • ErbB Receptors / genetics
  • Female
  • Forced Expiratory Volume
  • Genetic Predisposition to Disease / genetics
  • Humans
  • Lung Neoplasms / genetics*
  • Male
  • Middle Aged
  • Mutation / genetics
  • Proto-Oncogene Proteins p21(ras) / genetics*
  • Pulmonary Disease, Chronic Obstructive / genetics*
  • Sex Factors
  • Smoking / adverse effects
  • Vital Capacity

Substances

  • KRAS protein, human
  • ErbB Receptors
  • Proto-Oncogene Proteins p21(ras)

Grants and funding

The authors have no support or funding to report.