Cytomorphological identification of advanced pulmonary adenocarcinoma harboring KRAS mutation in lymph node fine-needle aspiration specimens: Comparative investigation of adenocarcinoma with KRAS and EGFR mutations

Background Kirsten rat sarcoma 2 viral oncogene homolog (KRAS) mutation in pulmonary adenocarcinoma is clinically important due to its association with resistance to EGFR inhibitors and poor prognosis. To our knowledge, there has not been a comparative study focusing on cytological nuclear features...

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Published in:Diagnostic cytopathology 2015-07, Vol.43 (7), p.539-544
Main Authors: Song, Dae Hyun, Lee, Boram, Shin, Yooju, Choi, In Ho, Ha, Sang Yun, Lee, Jae Jun, Hong, Min Eui, Choi, Yoon-La, Han, Joungho, Um, Sang-Won
Format: Article
Language:English
Subjects:
adenocarcinoma
Adenocarcinoma - diagnosis
Adenocarcinoma - genetics
Adenocarcinoma - metabolism
Adenocarcinoma - pathology
Aged
Biomarkers, Tumor - genetics
Biomarkers, Tumor - metabolism
Biopsy, Fine-Needle - methods
EGFR gene
endoscopic ultrasound-guided fine needle aspiration
Female
Gene Expression
Humans
Immunohistochemistry
KRAS gene
lung
Lung Neoplasms - diagnosis
Lung Neoplasms - genetics
Lung Neoplasms - metabolism
Lung Neoplasms - pathology
Lymph Nodes - metabolism
Lymph Nodes - pathology
Lymphatic Metastasis
Male
Middle Aged
Mutation
Proto-Oncogene Proteins p21(ras) - genetics
Proto-Oncogene Proteins p21(ras) - metabolism
Receptor, Epidermal Growth Factor - genetics
Receptor, Epidermal Growth Factor - metabolism
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Summary:Background Kirsten rat sarcoma 2 viral oncogene homolog (KRAS) mutation in pulmonary adenocarcinoma is clinically important due to its association with resistance to EGFR inhibitors and poor prognosis. To our knowledge, there has not been a comparative study focusing on cytological nuclear features of pulmonary adenocarcinoma harboring KRAS mutation (KRAS‐AD). Hence, we compared the cytomorphology of metastatic KRAS‐AD and EGFR‐positive adenocarcinoma (EGFR‐AD) in aspiration specimens from lymph nodes. Methods Forty lymph node aspiration specimens from forty KRAS‐AD patients were collected at Samsung Medical Center (Seoul, Korea) from 2009 to 2013. As a control group, 40 EBUS‐FNA lymph node specimens from 20 EGFR‐AD patients were collected. EGFR‐AD specimens were evaluated at Samsung Medical Center (Seoul, Korea) from 2012 to 2013. All 80 specimens were histologically confirmed to metastatic adenocarcinoma. Two pathologists performed a blinded review of all specimens. Results Compared with EGFR‐AD, KRAS‐AD exhibited more severe nuclear pleomorphism (P 
ISSN:8755-1039
1097-0339
DOI:10.1002/dc.23242