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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 |
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| container_end_page | 544 |
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| container_title | Diagnostic cytopathology |
| container_volume | 43 |
| creator | 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 |
| description | 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 |
| doi_str_mv | 10.1002/dc.23242 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1819138854</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1691014523</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4542-3e4faad4a6a9e03bd5252ff8eb84f247b2bf627d546d2e09d33ae62b5dfaae9d3</originalsourceid><addsrcrecordid>eNqFkstu1DAUhi0EokNB4gmQJTZsUnzLjV0V2gE6AlGKYGc58cmMS2IHO5kyL8rz4GGmw0VCrGwfff__H9sHoceUnFBC2HPdnDDOBLuDZpSUeUI4L--iWZGnaUIJL4_QgxCuCSElo9l9dMRSwXJWFjP0vdqMrnd-WLnOLU2jOmw02NG0cT8aZ7FrsdJrZRvQeJi63lnlN7EE1jXKN8a6XuGV8rXzxi7xxeXpB9xP405sLO42_bDC1mnArbGQWADdAVZhMH4HhQEa04MNL3Dl-kFty2uI2jWE0Sx_a-OPzBszrnZxymp8Nj-_POSGh-heq7oAj_brMfp4fnZVvUoW7-avq9NF0oj4BAkH0SqlhcpUCYTXOmUpa9sC6kK0TOQ1q9uM5ToVmWZASs25gozVqY4yiMdj9GznO3j3dYrtyt6EBrpOWXBTkLSgJeVFkYr_o1lJCRUp4xF9-hd67SZv40W2FGGioDn_Zdh4F4KHVg7e9PFzJCVyOxZSN_LnWET0yd5wqnvQB_B2DiKQ7IAb08Hmn0byZXVruOdNGOHbgVf-i8xynqfy09u5XCwurt7z6rN8w38AeCHVHQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1690248173</pqid></control><display><type>article</type><title>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</title><source>Wiley</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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 < 0.001), coarse chromatin (P = 0.001), cherry‐red nucleoli (P < 0.001) and naked tumor cells (P = 0.002) with necrotic (P < 0.001) and neutrophilic (P = 0.008) background.
Conclusions
Our study provides the first demonstration of cytomorphologic differentiation between metastatic KRAS‐AD and metastatic EGFR‐AD in lymph node aspiration specimens. Diagn. Cytopathol. 2015;43:539–544. © 2014 Wiley Periodicals, Inc.</description><identifier>ISSN: 8755-1039</identifier><identifier>EISSN: 1097-0339</identifier><identifier>DOI: 10.1002/dc.23242</identifier><identifier>PMID: 25427298</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>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</subject><ispartof>Diagnostic cytopathology, 2015-07, Vol.43 (7), p.539-544</ispartof><rights>2014 Wiley Periodicals, Inc.</rights><rights>2015 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4542-3e4faad4a6a9e03bd5252ff8eb84f247b2bf627d546d2e09d33ae62b5dfaae9d3</citedby><cites>FETCH-LOGICAL-c4542-3e4faad4a6a9e03bd5252ff8eb84f247b2bf627d546d2e09d33ae62b5dfaae9d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25427298$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Song, Dae Hyun</creatorcontrib><creatorcontrib>Lee, Boram</creatorcontrib><creatorcontrib>Shin, Yooju</creatorcontrib><creatorcontrib>Choi, In Ho</creatorcontrib><creatorcontrib>Ha, Sang Yun</creatorcontrib><creatorcontrib>Lee, Jae Jun</creatorcontrib><creatorcontrib>Hong, Min Eui</creatorcontrib><creatorcontrib>Choi, Yoon-La</creatorcontrib><creatorcontrib>Han, Joungho</creatorcontrib><creatorcontrib>Um, Sang-Won</creatorcontrib><title>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</title><title>Diagnostic cytopathology</title><addtitle>Diagn. Cytopathol</addtitle><description>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 < 0.001), coarse chromatin (P = 0.001), cherry‐red nucleoli (P < 0.001) and naked tumor cells (P = 0.002) with necrotic (P < 0.001) and neutrophilic (P = 0.008) background.
Conclusions
Our study provides the first demonstration of cytomorphologic differentiation between metastatic KRAS‐AD and metastatic EGFR‐AD in lymph node aspiration specimens. Diagn. Cytopathol. 2015;43:539–544. © 2014 Wiley Periodicals, Inc.</description><subject>adenocarcinoma</subject><subject>Adenocarcinoma - diagnosis</subject><subject>Adenocarcinoma - genetics</subject><subject>Adenocarcinoma - metabolism</subject><subject>Adenocarcinoma - pathology</subject><subject>Aged</subject><subject>Biomarkers, Tumor - genetics</subject><subject>Biomarkers, Tumor - metabolism</subject><subject>Biopsy, Fine-Needle - methods</subject><subject>EGFR gene</subject><subject>endoscopic ultrasound-guided fine needle aspiration</subject><subject>Female</subject><subject>Gene Expression</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>KRAS gene</subject><subject>lung</subject><subject>Lung Neoplasms - diagnosis</subject><subject>Lung Neoplasms - genetics</subject><subject>Lung Neoplasms - metabolism</subject><subject>Lung Neoplasms - pathology</subject><subject>Lymph Nodes - metabolism</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Proto-Oncogene Proteins p21(ras) - genetics</subject><subject>Proto-Oncogene Proteins p21(ras) - metabolism</subject><subject>Receptor, Epidermal Growth Factor - genetics</subject><subject>Receptor, Epidermal Growth Factor - metabolism</subject><issn>8755-1039</issn><issn>1097-0339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNqFkstu1DAUhi0EokNB4gmQJTZsUnzLjV0V2gE6AlGKYGc58cmMS2IHO5kyL8rz4GGmw0VCrGwfff__H9sHoceUnFBC2HPdnDDOBLuDZpSUeUI4L--iWZGnaUIJL4_QgxCuCSElo9l9dMRSwXJWFjP0vdqMrnd-WLnOLU2jOmw02NG0cT8aZ7FrsdJrZRvQeJi63lnlN7EE1jXKN8a6XuGV8rXzxi7xxeXpB9xP405sLO42_bDC1mnArbGQWADdAVZhMH4HhQEa04MNL3Dl-kFty2uI2jWE0Sx_a-OPzBszrnZxymp8Nj-_POSGh-heq7oAj_brMfp4fnZVvUoW7-avq9NF0oj4BAkH0SqlhcpUCYTXOmUpa9sC6kK0TOQ1q9uM5ToVmWZASs25gozVqY4yiMdj9GznO3j3dYrtyt6EBrpOWXBTkLSgJeVFkYr_o1lJCRUp4xF9-hd67SZv40W2FGGioDn_Zdh4F4KHVg7e9PFzJCVyOxZSN_LnWET0yd5wqnvQB_B2DiKQ7IAb08Hmn0byZXVruOdNGOHbgVf-i8xynqfy09u5XCwurt7z6rN8w38AeCHVHQ</recordid><startdate>201507</startdate><enddate>201507</enddate><creator>Song, Dae Hyun</creator><creator>Lee, Boram</creator><creator>Shin, Yooju</creator><creator>Choi, In Ho</creator><creator>Ha, Sang Yun</creator><creator>Lee, Jae Jun</creator><creator>Hong, Min Eui</creator><creator>Choi, Yoon-La</creator><creator>Han, Joungho</creator><creator>Um, Sang-Won</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>RC3</scope></search><sort><creationdate>201507</creationdate><title>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</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4542-3e4faad4a6a9e03bd5252ff8eb84f247b2bf627d546d2e09d33ae62b5dfaae9d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>adenocarcinoma</topic><topic>Adenocarcinoma - diagnosis</topic><topic>Adenocarcinoma - genetics</topic><topic>Adenocarcinoma - metabolism</topic><topic>Adenocarcinoma - pathology</topic><topic>Aged</topic><topic>Biomarkers, Tumor - genetics</topic><topic>Biomarkers, Tumor - metabolism</topic><topic>Biopsy, Fine-Needle - methods</topic><topic>EGFR gene</topic><topic>endoscopic ultrasound-guided fine needle aspiration</topic><topic>Female</topic><topic>Gene Expression</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>KRAS gene</topic><topic>lung</topic><topic>Lung Neoplasms - diagnosis</topic><topic>Lung Neoplasms - genetics</topic><topic>Lung Neoplasms - metabolism</topic><topic>Lung Neoplasms - pathology</topic><topic>Lymph Nodes - metabolism</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Proto-Oncogene Proteins p21(ras) - genetics</topic><topic>Proto-Oncogene Proteins p21(ras) - metabolism</topic><topic>Receptor, Epidermal Growth Factor - genetics</topic><topic>Receptor, Epidermal Growth Factor - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Song, Dae Hyun</creatorcontrib><creatorcontrib>Lee, Boram</creatorcontrib><creatorcontrib>Shin, Yooju</creatorcontrib><creatorcontrib>Choi, In Ho</creatorcontrib><creatorcontrib>Ha, Sang Yun</creatorcontrib><creatorcontrib>Lee, Jae Jun</creatorcontrib><creatorcontrib>Hong, Min Eui</creatorcontrib><creatorcontrib>Choi, Yoon-La</creatorcontrib><creatorcontrib>Han, Joungho</creatorcontrib><creatorcontrib>Um, Sang-Won</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><jtitle>Diagnostic cytopathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Song, Dae Hyun</au><au>Lee, Boram</au><au>Shin, Yooju</au><au>Choi, In Ho</au><au>Ha, Sang Yun</au><au>Lee, Jae Jun</au><au>Hong, Min Eui</au><au>Choi, Yoon-La</au><au>Han, Joungho</au><au>Um, Sang-Won</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Diagnostic cytopathology</jtitle><addtitle>Diagn. Cytopathol</addtitle><date>2015-07</date><risdate>2015</risdate><volume>43</volume><issue>7</issue><spage>539</spage><epage>544</epage><pages>539-544</pages><issn>8755-1039</issn><eissn>1097-0339</eissn><abstract>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 < 0.001), coarse chromatin (P = 0.001), cherry‐red nucleoli (P < 0.001) and naked tumor cells (P = 0.002) with necrotic (P < 0.001) and neutrophilic (P = 0.008) background.
Conclusions
Our study provides the first demonstration of cytomorphologic differentiation between metastatic KRAS‐AD and metastatic EGFR‐AD in lymph node aspiration specimens. Diagn. Cytopathol. 2015;43:539–544. © 2014 Wiley Periodicals, Inc.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>25427298</pmid><doi>10.1002/dc.23242</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| 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 |
| title | 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 |
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