Pleural invasion, epidermal growth factor receptor mutation and carcinoembryonic antigen level affect pleural lavage cytology-positive status in non-small-cell lung cancer

Abstract OBJECTIVES Pleural invasion (pl) is strongly associated with the pleural lavage cytology (PLC) status. We analysed tumours with pl and evaluated the relationship between the PLC status and pl. METHODS We retrospectively reviewed 428 surgically treated patients who had been diagnosed with non-small-cell lung cancer with pl and had their PLC status examined between 2000 and 2016. We investigated the influence of a PLC-positive status on the prognosis and searched for the factors predictive of a PLC-positive status. RESULTS Seventy-eight (18%) patients were PLC positive. The recurrence-free survival of PLC-positive patients was significantly worse than that of PLC-negative patients in pl1 and pl2, but not in pl3 (5-year recurrence-free survival rate, PLC positive versus PLC negative: pl1, 22.0% vs 60.0%, P = 0.002; pl2, 30.4% vs 59.7%, P = 0.015; pl3, 50.0% vs 59.6%, P = 0.427). A multivariable analysis showed that the degree of pl (pl2–3 versus pl1) [odds ratio (OR) 5.34, P < 0.001] was an independent predictive factor for PLC positivity. Epidermal growth factor receptor (EGFR) mutation positivity (OR 5.48, P = 0.042) and carcinoembryonic antigen (CEA) ≥5 ng/ml (OR 3.78, P = 0.042) were associated with a PLC-positive status in patients with pl2–3. We found that the PLC-positive rate in patients with pl2–3 was 35.6%; however, if the tumour was EGFR mutation positive and had CEA ≥5 ng/ml, the PLC-positive rate increased to 77%. CONCLUSIONS If a tumour was suspected of being pl2–3 and had EGFR mutation positivity and CEA ≥5 ng/ml, the PLC-positive rate was extremely high. Clinical trial registration number Hyogo Cancer Center, G-138.

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Pleural lavage cytology at thoracotomy in patients with completely resected non-small cell lung cancer

The Journal of the Japanese Association for Chest Surgery ◽

10.2995/jacsurg.20.898 ◽

2006 ◽

Vol 20 (7) ◽

pp. 898-903 ◽

Cited By ~ 1

Author(s):

Ryoji Kawano ◽

Toshiya Yokota ◽

Shingo Ikeda ◽

Enjo Hata

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Small Cell Lung ◽

Lavage Cytology ◽

Pleural Lavage Cytology ◽

Pleural Lavage

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Treatment of Advanced Non–Small-Cell Lung Cancer With Epidermal Growth Factor Receptor (EGFR) Mutation or ALK Gene Rearrangement: Results of an International Expert Panel Meeting of the Italian Association of Thoracic Oncology

Clinical Lung Cancer ◽

10.1016/j.cllc.2013.12.002 ◽

2014 ◽

Vol 15 (3) ◽

pp. 173-181 ◽

Cited By ~ 46

Author(s):

Cesare Gridelli ◽

Filippo de Marinis ◽

Federico Cappuzzo ◽

Massimo Di Maio ◽

Fred R. Hirsch ◽

...

Keyword(s):

Lung Cancer ◽

Epidermal Growth Factor Receptor ◽

Gene Rearrangement ◽

Egfr Mutation ◽

Expert Panel ◽

Growth Factor Receptor ◽

Small Cell ◽

International Expert ◽

Small Cell Lung ◽

Epidermal Growth

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Epidermal Growth Factor Receptor Mutations in Plasma DNA Samples Predict Tumor Response in Chinese Patients With Stages IIIB to IV Non–Small-Cell Lung Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2008.17.3930 ◽

2009 ◽

Vol 27 (16) ◽

pp. 2653-2659 ◽

Cited By ~ 193

Author(s):

Hua Bai ◽

Li Mao ◽

hang Shu Wang ◽

Jun Zhao ◽

Lu Yang ◽

...

Keyword(s):

Lung Cancer ◽

Egfr Mutation ◽

Tumor Response ◽

Growth Factor Receptor ◽

Small Cell ◽

Egfr Mutations ◽

Plasma Samples ◽

Plasma Dna ◽

Small Cell Lung ◽

Epidermal Growth

Purpose Mutations in the epidermal growth factor receptor (EGFR) kinase domain can predict tumor response to tyrosine kinase inhibitors (TKIs) in non–small-cell lung cancer (NSCLC). However, obtaining tumor tissues for mutation analysis is challenging. We hypothesized that plasma-based EGFR mutation analysis is feasible and has value in predicting tumor response in patients with NSCLC. Patients and Methods Plasma DNA samples and matched tumors from 230 patients with stages IIIB to IV NSCLC were analyzed for EGFR mutations in exons 19 and 21 by using denaturing high-performance liquid chromatography. We compared the mutations in the plasma samples and the matched tumors and determined an association between EGFR mutation status and the patients' clinical outcomes prospectively. Results In 230 patients, we detected 81 EGFR mutations in 79 (34.3%) of the patients' plasma samples. We detected the same mutations in 63 (79.7%) of the matched tumors. Sixteen plasma (7.0%) and fourteen tumor (6.1%) samples showed unique mutations. The mutation frequencies were significantly higher in never-smokers and in patients with adenocarcinomas (P = .012 and P = .009, respectively). In the 102 patients who failed platinum-based treatment and who were treated with gefitinib, 22 (59.5%) of the 37 with EGFR mutations in the plasma samples, whereas only 15 (23.1%) of the 65 without EGFR mutations, achieved an objective response (P = .002). Patients with EGFR mutations had a significantly longer progression-free survival time than those without mutations (P = .044) in plasma. Conclusion EGFR mutations can be reliably detected in plasma DNA of patients with stages IIIB to IV NSCLC and can be used as a biomarker to predict tumor response to TKIs.

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