Molecular diagnostic algorithm for epidermal growth factor receptor mutation detection in Asian lung adenocarcinomas: comprehensive analyses of 445 Taiwanese patients with immunohistochemistry, PCR-direct sequencing and Scorpion/ARMS methods.

摘要: Background and objective Therapeutic responses of lung adenocarcinoma patients to tyrosine kinase inhibitors (TKIs) epidermal growth factor receptor (EGFR) are closely associated with activating mutations within the EGFR domain. Screening prior selection for therapeutic strategy has been considered extremely valuable clinical management in Asian countries including Taiwan, where mutation rate is higher than rest world. Currently there no consensus on method choice assess tumour tissue. Methods We enrolled 445 analysis using polymerase chain reaction (PCR)-direct sequencing, scorpion/amplified refractory system (ARMS) technology immunohistochemistry mutation-specific antibodies. Results Two hundred forty-five (245/445; 55%) were found harbour PCR-direct sequencing method, a majority (233/245; 95%) carrying exon 19 deletion or p.L858R point mutations. One three 200 negative from further analysed Scorpion/ARMS technology. Up 30% turned out be positive tests. For mutations, p.E746_A750del specific antibody showed sensitivity 57% specificity 100% deletions while 68% 95%. Conclusions Based this study, we proposed an algorithm comprehensive efficient testing Asia.