Tao Lu1, Qiang Li2, Lan Li3, Kaizhen Yang4, Danfei Zhou5, Jie Gao1, Minjiang Chen6, Yan Xu6, Wei Zhong6, Mengzhao Wang6, Zhiyong Liang1, Jing Zhao6. 1. Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China. 2. Department of Respiratory Medicine, Beijing No.6 Hospital, Beijing 100007, China. 3. Department of Respiratory Medicine Ward 3, Shijiazhuang People's Hospital, Shijiazhuang 050000, China. 4. Department of Respiratory Medicine, Bayannur City Hospital, Bayannur 015000, China. 5. Department of Respiratory Medicine, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo 315000, China. 6. Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Abstract
BACKGROUND: The lack of pathological quality control standard in detecting epidermal growth factor receptor (EGFR) gene mutation in malignant pleural effusion leads to confusion in the interpretation of detection results and the clinical use of EGFR-tyrosine kinase inhibitor (TKI). Therefore, it is very important to propose quality control standards and guide the detection of EGFR mutation in pleural effusion. The aim of this study is to retrospectively analyze the results of EGFR gene mutation in pleural effusion sediment section according to strict pathological quality control standards, and the therapeutic effect of EGFR-TKIs guided by this detection results. METHODS: From January 2012 to June 2018, the clinical data of patients with pleural effusion collected from Department of Pathology of Peking Union Medical College Hospital were analyzed retrospectively. Among them, 132 patients with relatively complete clinical data and with EGFR gene mutation detection of paraffin-embedded pleural effusion sediment section according to the established quality control standard were included. According to the results of EGFR gene mutation, it was divided into positive group and negative group, and the efficacy of EGFR-TKIs in different groups was compared. RESULTS: After the centrifugation of pleural effusion, the sediment was embedded in paraffin, sectioned, and observed under the microscope after HE staining. If the number of tumor cells ≥100, it met the pathological quality control standard, and it could be used for subsequent EGFR gene mutation detection. EGFR gene mutations were detected in 72 (54.5%) of 132 patients. EGFR-TKIs were used in 69 of 72 mutation positive patients. Of 60 EGFR mutation negative patients, only 15 used EGFR-TKIs. In EGFR mutation positive group, the disease control rate (DCR) was 95.8%, and the median progression-free survival (PFS) was 11 months. In EGFR mutation negative group, the DCR was 0%, and the median PFS was 1 month. The DCR and PFS were significantly different between the two groups (P<0.05). CONCLUSIONS: According to the pathological quality control standards, the embedded section of pleural fluid sediment can be used to detect EGFR gene mutation, and the results can be used to guide the clinical use of EGFR-TKIs.
BACKGROUND: The lack of pathological quality control standard in detecting epidermal growth factor receptor (EGFR) gene mutation in malignant pleural effusion leads to confusion in the interpretation of detection results and the clinical use of EGFR-tyrosine kinase inhibitor (TKI). Therefore, it is very important to propose quality control standards and guide the detection of EGFR mutation in pleural effusion. The aim of this study is to retrospectively analyze the results of EGFR gene mutation in pleural effusion sediment section according to strict pathological quality control standards, and the therapeutic effect of EGFR-TKIs guided by this detection results. METHODS: From January 2012 to June 2018, the clinical data of patients with pleural effusion collected from Department of Pathology of Peking Union Medical College Hospital were analyzed retrospectively. Among them, 132 patients with relatively complete clinical data and with EGFR gene mutation detection of paraffin-embedded pleural effusion sediment section according to the established quality control standard were included. According to the results of EGFR gene mutation, it was divided into positive group and negative group, and the efficacy of EGFR-TKIs in different groups was compared. RESULTS: After the centrifugation of pleural effusion, the sediment was embedded in paraffin, sectioned, and observed under the microscope after HE staining. If the number of tumor cells ≥100, it met the pathological quality control standard, and it could be used for subsequent EGFR gene mutation detection. EGFR gene mutations were detected in 72 (54.5%) of 132 patients. EGFR-TKIs were used in 69 of 72 mutation positive patients. Of 60 EGFR mutation negative patients, only 15 used EGFR-TKIs. In EGFR mutation positive group, the disease control rate (DCR) was 95.8%, and the median progression-free survival (PFS) was 11 months. In EGFR mutation negative group, the DCR was 0%, and the median PFS was 1 month. The DCR and PFS were significantly different between the two groups (P<0.05). CONCLUSIONS: According to the pathological quality control standards, the embedded section of pleural fluid sediment can be used to detect EGFR gene mutation, and the results can be used to guide the clinical use of EGFR-TKIs.
Authors: Yi-Long Wu; Ying Cheng; Xiangdong Zhou; Ki Hyeong Lee; Kazuhiko Nakagawa; Seiji Niho; Fumito Tsuji; Rolf Linke; Rafael Rosell; Jesus Corral; Maria Rita Migliorino; Adam Pluzanski; Eric I Sbar; Tao Wang; Jane Liang White; Sashi Nadanaciva; Rickard Sandin; Tony S Mok Journal: Lancet Oncol Date: 2017-09-25 Impact factor: 41.316
Authors: Keunchil Park; Eng-Huat Tan; Ken O'Byrne; Li Zhang; Michael Boyer; Tony Mok; Vera Hirsh; James Chih-Hsin Yang; Ki Hyeong Lee; Shun Lu; Yuankai Shi; Sang-We Kim; Janessa Laskin; Dong-Wan Kim; Catherine Dubos Arvis; Karl Kölbeck; Scott A Laurie; Chun-Ming Tsai; Mehdi Shahidi; Miyoung Kim; Dan Massey; Victoria Zazulina; Luis Paz-Ares Journal: Lancet Oncol Date: 2016-04-12 Impact factor: 41.316