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Abstract
Background
Lymph node status is the most important prognostic factor in resectable non-small cell lung cancer (NSCLC). Considering the critical importance of lymph nodes, determining N status and related molecular biomarkers may contribute to the literature for understanding the pathogenesis in the early stage and shedding light on treatment.
Materials and methods
71 patients with lung adenocarcinoma and lymph node metastasis were included. Next-generation sequencing (NGS) was performed on metastatic lymph samples at the Molecular Pathology Laboratory of Aydın Adnan Menderes University Faculty of Medicine, Turkey. The gender, age, N Status and mutation results were analyzed.
Results
Mutation was detected in 46 patients (69%). The most frequently observed mutations included Tumor Protein 53 (TP53) (17, 23.9%), Kirsten rat sarcoma 2 viral oncogene homolog (KRAS) (11, 15.5%), Epidermal Growth Factor Receptor (EGFR) (10, 14.1%), Phosphatase and tension homolog (PTEN) (9, 12.7%), Neurofibromatosis type 1 (NF1) (5, 7%) and B-Raf proto-oncogene, serine/threonine kinase (BRAF) (3, 4.2%). A statistically significant increase in mutation frequency was observed with advancing N stage (p < 0.01). Additionally, the number of patients with multiple mutation associations also increased with higher N stages. Although the increase in TP53, PTEN, and KRAS mutation rates with higher N stages did not reach statistical significance, a correlation was observed (p = 0.09, p = 0.07, and p = 0.06, respectively). Notably, KRAS G12C mutations were exclusively detected in advanced N stages.
Conclusion
Our study reveals the mutation profile in lymph node metastases in different locations in patients with lung adenocarcinoma. We hope that this new information will contribute to the literature on early prevention of distant metastases.