Abstract

In this study, we investigated the frequency of Epidermal growth factor receptor (EGFR) gene mutations, the level of EGFR mRNA and protein expressions in Turkish population for indicating substantial differences in the frequency of EGFR mutations, EGFR amplification and EGFR protein expression between populations and the effect of these parameters in response to EGFR tyrosine kinase inhibitors. The study included 34 patients with non-small cell lung cancers. The RNA and DNA were extracted from the normal and tumor side of the lung tissue removed by surgery. To investigate the most common mutations in the EGFR gene, exon 19 was sequenced and mutation specific PCR was performed for detecting the L858R mutation in exon 21. EGFR mRNA expression was measured by relative quantitative reverse transcription PCR. The EGFR protein levels were detected with immunohistochemistry methods from the sections of the patients' paraffin blocks. No EGFR mutation in exon 19 or L858R mutation in exon 21 were detected in the patients. Overexpression of EGFR gene mRNA was identified in 16 of 34 (%47) patients and overexpression of EGFR protein was detected in 15 of 34 (%44) patients. Statistical analysis was not significant for the correlation between sex, age, smoking, histopathology, pathological stage and overexpression of EGFR mRNA and protein. It was found that in Turkish population, EGFR mutation in exon 19 and L858R mutation were very rare, EGFR protein expression was similar and EGFR mRNA expression significantly increased compared to the literature. Markedly increased EGFR mRNA expression ratios in the absence of activating mutations showed that identifying the EGFR mRNA expression level for prediction of response to EGFR tyrosine kinase inhibitors might be significant in the Turkish population.

Highlights

  • Lung cancer is one of the most common cancers in humans and is the most common cause of death from cancer in the world

  • No Epidermal growth factor receptor (EGFR) mutation in exon 19 or L858R mutation in exon 21 were detected in the patients

  • It was found that in Turkish population, EGFR mutation in exon 19 and L858R mutation were very rare, EGFR protein expression was similar and EGFR mRNA expression significantly increased compared to the literature

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Summary

Introduction

Lung cancer is one of the most common cancers in humans and is the most common cause of death from cancer in the world. Non-small cell lung cancer (NSCLC) constitutes about 85% of lung cancers and it is divided into subgroups as squamous cell carcinoma, adenocarcinoma, large cell carcinoma and others [1]. The treatment of lung cancer is planned mainly according to the stage of the cancer, the patient’s performance status and comorbid diseases. A large proportion of patients with NSCLC are diagnosed at stage 3 and stage 4, and chemotherapy is usually recommended as the first-line treatment option [2]. Chemotherapy is very toxic, especially for the elderly and patients with poor performance. In recent years there are efforts for developing targeted molecular-based drugs

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