Objective To explore the clinicopathological features and prognosis of the patients newly diagnosed with lung adenocarcinoma with both EGFR mutation and C-MET amplification.Methods The pathological sections were reviewed.EGFR mutation was detected by amplification refractory mutation system-quantitative real-time polymerase chain reaction,and C-MET amplification by fluorescence in situ hybridization.The clinicopathological features and survival data of the patients newly diagnosed with lung adenocarcinoma with both EGFR mutation and C-MET amplification were analyzed retrospectively.Results In 11 cases of EGFR mutation combined with C-MET amplification,complex glands and solid high-grade components were observed under a microscope in 10 cases except for one case with a cell block,the tissue structure of which was difficult to be evaluated.The incidence of lung adenocarcinoma in the patients with EGFR mutation combined with C-MET amplification at clinical stage Ⅳ was higher than that in the EGFR mutation or C-MET amplification group (all P<0.001),whereas the difference was not statistically significant between the EGFR mutation group and C-MET amplification group at each clinical stage (all P>0.05).There was no significant difference in the trend of survival rate between EGFR gene group and C-MET amplification group (χ2=0.042,P=0.838),while the survival of the patients with EGFR mutation combined with C-MET amplification was worse than that of the patients with EGFR mutation (χ2=246.72,P<0.001) or C-MET amplification (χ2=236.41,P<0.001).Conclusions The patients newly diagnosed with lung adenocarcinoma with EGFR mutation plus C-MET amplification demonstrate poor histological differentiation,rapid progress,and poor prognosis.The patients are often in the advanced stage when being diagnosed with cancer.Attention should be paid to this concurrent adverse driving molecular event in clinical work.With increasing availability,the inhibitors targeting C-MET may serve as an option to benefit these patients in the near future.
目的 探讨初治肺腺癌患者驱动基因EGFR突变和C-MET扩增共存的临床病理特征、预后。方法 复阅病理切片,应用扩增阻遏突变系统—实时荧光定量聚合酶链反应检测EGFR基因突变,应用荧光原位杂交检测C-MET扩增,回顾性分析EGFR突变和C-MET扩增共存初治肺腺癌的临床病理及随访资料。结果 11例EGFR突变合并C-MET扩增的送检组织中除1例难以评估组织结构的细胞块,其他10例均出现复杂腺体和实性的高级别成分。临床Ⅳ期的EGFR突变合并C-MET扩增组患病率显著高于EGFR突变组和C-MET扩增组,差异有统计学意义(P均<0.001);而EGFR突变组和C-MET扩增组在各临床分期的患病率差异均无统计学意义(P均>0.05)。EGFR基因和C-MET扩增组间的生存率变化差异无统计学意义(χ2=0.042,P=0.838),而EGFR突变合并C-MET扩增组患者的生存状况显著差于EGFR突变组(χ2=246.72,P<0.001)和C-MET扩增组(χ2=236.41,P<0.001)。结论 EGFR突变叠加C-MET扩增的初治肺腺癌组织学分化较差、进展快、预后差,首诊时往往已经是癌症晚期,临床需重视这种并发的不良驱动分子事件,随着C-MET靶向抑制剂的可及性增加,这部分叠加分子事件的肺腺癌患者将可能从EGFR与C-MET双靶用药中获益。.
Keywords: C-MET amplification; EGFR gene; lung adenocarcinoma.