The diagnostic accuracy of pleural effusion and plasma samples versus tumour tissue for detection of EGFR mutation in patients with advanced non-small cell lung cancer: comparison of methodologies.

Abstract

AIMS:

To evaluate the suitability of malignant pleural effusion (MPE) and plasma as surrogate samples for epidermal growth factor receptor (EGFR) mutation detection, and compare three different detection methods.

METHODS:

Matched tissue and plasma samples were collected from patients with advanced non-small cell lung cancer (NSCLC) (stage IIIB/IV adenocarcinoma/adenosquamous carcinoma), with matched MPE samples collected from a subgroup. DNA was extracted from tissue, MPE cell block, MPE supernatant and plasma before mutation detection by amplification refractory mutation system (ARMS) (all samples), Sanger sequencing and mutant-specific immunohistochemistry (IHC) (tissue and MPE cell blocks only).

RESULTS:

Sensitivity of MPE cell block, MPE supernatant and plasma versus tissue: 81.8% (9/11), 63.6% (7/11) and 67.5% (27/40); specificity was 80.0% (8/10), 100% (10/10) and 100% (46/46), respectively. Sensitivity of Sanger sequencing versus ARMS: 81.8% (27/33) for tissue, 40% (4/10) for MPE cell blocks; specificity was 100% (36/36 and 12/12) for both. Sensitivity of mutant-specific IHC versus ARMS: 54.8% (17/31) for tissue, 50.0% (6/12) for MPE cell blocks; specificity was 97.1% (34/35) and 100% (14/14), respectively.

CONCLUSIONS:

MPE and plasma are valid surrogates for NSCLC tumour EGFR mutation detection when tissue is not available. ARMS is most suitable for mutation detection in tissue and MPE cell blocks; however, mutant-specific IHC could be a complementary method when DNA-based molecular testing is unavailable.

• Authors: Xiaoqing Liu, Yachao Lu, Guanshan Zhu, Yao Lei, Li Zheng, Haifeng Qin, Chuanhao Tang, Gillian Ellison, Rose McCormack, Qunsheng Ji
• Journal: Journal of clinical pathology (J Clin Pathol) Vol. 66 Issue 12 Pg. 1065-9 (Dec 2013) ISSN: 1472-4146 [Electronic] England
• PMID: 23888061 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• DNA, Neoplasm
• ErbB Receptors

Topics

• Adenocarcinoma (genetics, metabolism, pathology)
• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Adenosquamous (genetics, metabolism, pathology)
• Carcinoma, Non-Small-Cell Lung (genetics, metabolism, pathology)
• China
• DNA, Neoplasm (chemistry, genetics)
• ErbB Receptors (genetics, metabolism)
• Female
• Humans
• Immunohistochemistry
• Lung Neoplasms (genetics, metabolism, pathology)
• Male
• Middle Aged
• Mutation
• Plasma
• Pleural Effusion, Malignant (genetics, metabolism, pathology)
• Sensitivity and Specificity
• Sequence Analysis, DNA