Can EGFR mutation status be reliably determined in pre‐operative needle biopsies from adenocarcinomas of the lung? |
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| Authors: | Kim Hein Lindahl Flemming Brandt Sørensen Søren Peter Jonstrup Karen Ege Olsen Siegfried Loeschke |
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| Affiliation: | 1. Department of Pathology, Vejle Hospital, part of Lillebaelt Hospital, Vejle, Denmark;2. Department of Pathology, Odense University Hospital, Odense, Denmark;3. Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark;4. Department of Pathology, Southern Jutland Hospital, Soenderborg, Denmark |
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| Abstract: | The identification of EGFR mutations in non‐small‐cell lung cancer is important for selecting patients, who may benefit from treatment with EGFR tyrosine kinase inhibitors. The analysis is usually performed on cytological aspirates and/or histological needle biopsies, representing a small fraction of the tumour volume. The aim of the present investigation was to evaluate the diagnostic performance of this molecular test. We retrospectively included 201 patients with primary adenocarcinoma of the lung. EGFR mutation status (exon 19 deletions and exon 21 L858R point mutation) was evaluated on both pre‐operative biopsies (131 histological and 70 cytological) and on the surgical specimens, using PCR. Samples with low tumour cell fraction were assigned to laser micro‐dissection (LMD). We found nine (4.5%) patients with EGFR mutation in the lung tumour resections, but failed to identify mutation in one of the corresponding pre‐operative, cytological specimens. Several (18.4%) analyses of the pre‐operative biopsies were inconclusive, especially in case of biopsies undergoing LMD and regarding exon 21 analysis. Discrepancy of mutation status in one patient may reflect intra‐tumoural heterogeneity or technical issues. Moreover, several inconclusive results in the diagnostic biopsies reveal that attention must be paid on the suitability of pre‐operative biopsies for EGFR mutation analysis. |
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| Keywords: | Epidermal growth factor receptor lung adenocarcinoma mutation needle biopsy tumour heterogeneity |
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