Clinical and molecular analysis of synchronous double lung cancers

• Published in: Lung cancer (Amsterdam, Netherlands) Vol. 77; no. 2; pp. 281 - 287
• Main Authors: Arai, Junichi, Tsuchiya, Tomoshi, Oikawa, Masahiro, Mochinaga, Koji, Hayashi, Tomayoshi, Yoshiura, Koh-ichiro, Tsukamoto, Kazuhiro, Yamasaki, Naoya, Matsumoto, Keitaro, Miyazaki, Takuro, Nagayasu, Takeshi
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ireland Ltd 01.08.2012; Elsevier
• Subjects: Adult; Aged; Array comparative genomic hybridization; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - genetics; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - secondary; Comparative Genomic Hybridization; Diagnosis; Epidermal growth factor receptor; Female; Hematology, Oncology and Palliative Medicine; Humans; Intrapulmonary metastasis; Lung Neoplasms - genetics; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - secondary; Male; Medical sciences; Middle Aged; Mutation; Neoplasm Staging; Neoplasms, Second Primary - genetics; Neoplasms, Second Primary - mortality; Neoplasms, Second Primary - pathology; Non small cell lung cancer; Pneumology; Prognosis; Pulmonary/Respiratory; Receptor, Epidermal Growth Factor - genetics; Survival Analysis; Synchronous double cancers; Tumors; Tumors of the respiratory system and mediastinum; Synchronous double cancers; Array comparative genomic hybridization; Prognosis; Non small cell lung cancer; Intrapulmonary metastasis; Diagnosis; Epidermal growth factor receptor; Lung disease; Respiratory disease; Lung cancer; Hybridization; Metastasis; Malignant tumor; non-small cell lung carcinoma; Array; Synchronous; Growth factor receptor; Cancerology; Epidermal growth factor; Bronchus disease; Cancer; Pneumology
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2012.04.003

Abstract Background Since multiple lung cancer treatment strategies differ, it is essential for clinicians to be able to distinguish between separate primary lesions and metastasis. In the present study, we used array comparative genomic hybridization (aCGH) and somatic mutation (epidermal growth factor receptor: EGFR) to analyze genomic alteration profiles in lung cancer patients. To validate the consistency among the pathological assessments and clarify the clinical differences between double primary lesions and metastasis, we also examined synchronous double lung cancer clinical data. Methods Between January 1970 and March 2010, 2215 patients with lung cancer underwent surgical resection at Nagasaki University Hospital. We performed molecular analysis of 12 synchronous double lung cancer patients without lymph node metastasis (intrapulmonary metastasis in the same lobe (pm1): n = 6, primary: n = 6). We then evaluated the clinical outcomes of patients with pathologically diagnosed synchronous double lung cancers (intrapulmonary metastasis (pm): n = 80, primary: n = 39) and other T3 tumors ( n = 230). Results Examination of the concordance rate (CR) of the copy number changes (CNCs) for paired tumors showed that the metastasis group was larger than the primary group (55.5% vs. 19.6%, p = 0.04). Pathological diagnosis and molecular classification were the same in 10 out of 12 cases (83%). As compared to the primary group, there tended to be an inferior 5-year survival curve for the pm group. However, in N0 patients, the survival curve for the pm group overlapped the primary group, while the survival rate of the pm1 group was much higher than that of other T3 group ( p < 0.01). Conclusions Both pathological and molecular assessment using aCGH adapted in the current study appeared to have a consistency. Pathological pm1(T3)N0 patients may have a better prognosis than other T3N0 patients.