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High mutational concordance between primary colorectal tumors and associated pulmonary metastases.

原发性结直肠肿瘤与相关肺转移之间的高度突变一致性。

  • 影响因子:2.88
  • DOI:10.1002/jso.25871
  • 作者列表:"Corsini EM","Datar SS","Mitchell KG","Zhou N","Hofstetter WL","Mehran RJ","Rajaram R","Rice DC","Roth JA","Sepesi B","Swisher SG","Vaporciyan AA","Walsh GL","Blackmon SH","Loree JM","Morris VK","Antonoff MB
  • 发表时间:2020-05-01
Abstract

BACKGROUND AND OBJECTIVES:Precision medicine has altered the management of colorectal cancer (CRC). However, the concordance of mutational findings between primary CRC tumors and associated pulmonary metastases (PM) is not well-described. This study aims to determine the concordance of genomic profiles between primary CRC and PM. METHODS:Patients treated for colorectal PM at a single institution from 2000 to 2017 were identified. Mutational concordance was defined as either both wild-type or both mutant alleles in lung and colorectal lesion; genes with opposing mutational profiles were reported as discordant. RESULTS:Thirty-eight patients met inclusion criteria, among whom KRAS, BRAF, NRAS, MET, RET, and PIK3CA were examined for concordance. High concordance was demonstrated among all evaluated genes, ranging from 86% (KRAS) to 100% concordance (NRAS, RET, and MET). De novo KRAS mutations were detected in the PM of 4 from 35 (11%) patients, 3 of whom had previously received anti-epidermal growth factor receptor (EGFR) therapy. Evaluation of Cohen's κ statistic demonstrated moderate to perfect correlation among evaluated genes. CONCLUSIONS:Because high intertumoral genomic homogeneity exists, it may be reasonable to use primary CRC mutational profiles to guide prognostication and targeted therapy for PM. However, the possibility of de novo KRAS-mutant PM should be considered, particularly among patients previously treated with anti-EGFR therapy.

摘要

背景和目的: 精准医学已经改变了结直肠癌 (CRC) 的管理。然而,原发性CRC肿瘤和相关肺转移 (PM) 之间的突变结果的一致性没有得到很好的描述。本研究旨在确定原发性CRC和PM之间的基因组谱的一致性。 方法: 确定 2000 年至 2017 年在单一机构接受结直肠PM治疗的患者。突变一致性被定义为肺和结直肠病变中的野生型或两个突变等位基因; 具有相反突变谱的基因被报告为不一致的。 结果: 38 例患者符合纳入标准,其中KRAS、BRAF、NRAS、met、RET和PIK3CA检查一致性。在所有评估的基因中表现出高一致性,范围从 86% (KRAS) 到 100% 一致性 (NRAS、RET和MET)。在来自 35 名 (11%) 患者的 4 名患者的PM中检测到从头KRAS突变,其中 3 名先前接受过抗表皮生长因子受体 (EGFR) 治疗。Cohen的 κ 统计量的评估证明了所评估的基因之间的中度至完全相关性。 结论: 由于存在高肿瘤间基因组同质性,因此使用原发性CRC突变谱来指导PM的预后和靶向治疗可能是合理的。然而,应该考虑新生KRAS突变PM的可能性,特别是在先前接受抗EGFR治疗的患者中。

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影响因子:6.93
发表时间:2020-01-15
DOI:10.1002/ijc.32532
作者列表:["Hata A","Nakajima T","Matsusaka K","Fukuyo M","Morimoto J","Yamamoto T","Sakairi Y","Rahmutulla B","Ota S","Wada H","Suzuki H","Matsubara H","Yoshino I","Kaneda A"]

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影响因子:6.93
发表时间:2020-01-01
DOI:10.1002/ijc.32530
作者列表:["Zhang L","Yang Y","Chai L","Bu H","Yang Y","Huang H","Ran J","Zhu Y","Li L","Chen F","Li W"]

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肺肿瘤方向

肺肿瘤,又叫支气管肺癌,是常见的恶性肿瘤之一。肺肿瘤的治疗为包括手术、中药、放疗、化疗及免疫等多学科的综合治疗。

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