Frequent EGFR mutations in malignant pleural effusion of lung adenocarcinoma

¹ Dept of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
² Division of Critical Care Medicine, Dept of Emergency and Critical Care Medicine, Lotung Poh-Ai Hospital, Yi-Lan, Taiwan
³ Dept of Pathology, National Taiwan University Hospital, Taipei, Taiwan
⁴ Dept of Oncology, National Taiwan University Hospital, Taipei, Taiwan
⁵ Dept of Surgery, National Taiwan University Hospital, Taipei, Taiwan

^* To whom correspondence should be addressed. E-mail: jyshih{at}ntu.edu.tw.

	Abstract

Malignant pleural effusions (MPEs) are often observed in lung cancer, especially adenocarcinoma. Epidermal growth factor receptor (EGFR) mutations are usually detected in lung adenocarcinoma. The purpose of this study was to investigate the EGFR mutation rate in MPEs of lung adenocarcinoma.

Between June 2005 and December 2006, 136 MPEs from lung adenocarcinoma were collected for EGFR mutation detection. In addition, between April 2001 and November 2004, 91 surgically resected specimens of lung adenocarcinoma from patients without MPEs were assessed for EGFR mutation

The EGFR mutation rate was higher in the patients with MPEs than in the patients whose surgically resected specimens (68.4% vs. 50.5%, p=0.007). The EGFR mutation rate in patients with MPEs was not associated with gender, smoking history, age or cancer stage. By multivariate analysis, an age of less than 65 (p=0.011), never smoking (p=0.027), ECOG PS 0–1 (p<0.001), and EGFR mutation (p=0.001) were associated with a longer overall survival for lung adenocarcinoma patients with MPEs.

The patients with MPEs related to lung adenocarcinoma had a higher EGFR mutation rate than the surgically resected specimens. EGFR TKIs may be the treatment of choice for lung adenocarcinoma with MPEs in East Asia.

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