Pulmonary Pleomorphic Carcinoma: A Clinicopathological Study Including EGFR Mutation Analysis

• Published in: Journal of thoracic oncology Vol. 5; no. 4; pp. 460 - 465
• Main Authors: Kaira, Kyoichi, Horie, Yoshiki, Ayabe, Eriko, Murakami, Haruyasu, Takahashi, Toshiaki, Tsuya, Asuka, Nakamura, Yukiko, Naito, Tateaki, Endo, Masahiro, Kondo, Haruhiko, Nakajima, Takashi, Yamamoto, Nobuyuki
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2010; International Association for the Study of Lung Cancer
• Subjects: 18F-FDG PET; Adenocarcinoma - drug therapy; Adenocarcinoma - genetics; Adenocarcinoma - pathology; Adenocarcinoma, Bronchiolo-Alveolar - drug therapy; Adenocarcinoma, Bronchiolo-Alveolar - genetics; Adenocarcinoma, Bronchiolo-Alveolar - pathology; Aged; Aged, 80 and over; Biomarkers, Tumor - metabolism; EGFR mutation; Female; Humans; Immunoenzyme Techniques; Ki-67 Antigen - metabolism; Ki-67 labeling index; Lung Neoplasms - drug therapy; Lung Neoplasms - genetics; Lung Neoplasms - pathology; Male; Middle Aged; Mutation - genetics; Neoplasm Staging; Protein Kinase Inhibitors - therapeutic use; Proto-Oncogene Proteins - genetics; Proto-Oncogene Proteins p21(ras); Pulmonary pleomorphic carcinoma; Quinazolines - therapeutic use; ras Proteins - genetics; Receptor, Epidermal Growth Factor - antagonists & inhibitors; Receptor, Epidermal Growth Factor - genetics; Retrospective; Retrospective Studies; Survival Rate; Treatment Outcome; EGFR mutation; Ki-67 labeling index; 18F-FDG PET; Retrospective; Pulmonary pleomorphic carcinoma
• ISSN: 1556-0864; 1556-1380
• DOI: 10.1097/JTO.0b013e3181ce3e3c

Pulmonary pleomorphic carcinoma is a rare epithelial tumor and has an aggressive clinical course. As few studies of pulmonary pleomorphic carcinoma have been described, the clinicopathological characteristics of the disease remain unclear. Especially, the information on the epidermal growth factor receptor (EGFR) mutation status of pulmonary pleomorphic carcinoma is sparse. We retrospectively examined 17 patients with pulmonary pleomorphic carcinoma. EGFR mutation and Ki-67 labeling index were investigated in these patients. The median age of the patients was 72 years (range, 47–84 years). Thirteen patients were men and four were women. EGFR mutation was observed in 3 (18%) of 17 patients. The median value of Ki-67 labeling index was 62% (range, 20–87%). Positron emission tomography with 18-fluorodeoxy-glucose was performed in 16 patients, and the standardized uptake value tended to be high (median 19.3). The survival of patients without surgery demonstrated a significantly poor prognosis compared with those with surgery (P = 0.0096). Palliative chemotherapy was almost poor response in advanced pulmonary pleomorphic carcinoma. The response to gefitinib in a patient with EGFR mutation was small and transient. EGFR mutation was recognized in approximately 20% of patients with pulmonary pleomorphic carcinoma. It is necessary to investigate whether the use of a molecular targeting drug improves outcome for pulmonary pleomorphic carcinoma.