Negative NKX2-1 (TTF-1) as Temporary Surrogate Marker for Treatment Selection During EGFR-Mutation Analysis in Patients with Non–Small-Cell Lung Cancer

摘要: Introduction In the past decade, major progress has been made toward personalized medical treatment of non–small-cell lung cancer (NSCLC) through discovery epithelial growth factor receptor ( EGFR ) mutations. However, mutation analysis takes extra time and additional costs in diagnostic evaluation patients. It hypothesized that mutations are restricted to terminal respiratory unit -type adenocarcinoma expressing thyroid transcription factor-1 (official symbol NKX2-1) as determined by immunohistochemistry. The aim current study is evaluate potential NKX2-1 immunohistochemistry a prescreening test for analysis. Methods From 2004 December 2010, 810 consecutive NSCLC tumor specimens were tested routine procedure. Immunohistochemistry was performed (clone 8G7G3/1 [Dako]) results compared with -mutation status clinicopathological characteristics. Results detected 114 (14%). expression present 68%. cases mutation, staining positive 92%. immunohistochemical (IHC) significantly associated presence p = 5.3×10 −10 ). increased negative predictive value more than 95%. Conclusions case IHC staining, only if clinically urgent, high 95% suitable temporary surrogate marker choice starting chemotherapy. IHC, best strategy wait outcome then choose appropriate treatment.