SMARCA4突变非小细胞肺癌患者的临床特征和预后生物标志物。

IF 4 2区医学 Q2 ONCOLOGY

Translational lung cancer research Pub Date : 2024-08-31 Epub Date: 2024-08-19 DOI:10.21037/tlcr-24-381

Jinyu Long, Ying Chen, Xingguang Luo, Ruiying Rao, Chenxi Wang, Yuxin Guo, Jinhe Xu, Ping Lin, Yingfang Song, Lijuan Qu, Qinghong Liu, Jun Lu, Chengzhi Zhou, Zhengbo Song, Xiandong Lin, Hiroyuki Adachi, Jacek Jassem, Masatsugu Hamaji, Zongyang Yu

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引用次数: 0

摘要

背景：携带SMARCA4突变（SMARCA4-Mut）的非小细胞肺癌（NSCLC）患者往往病情较晚，预后较差。然而，由于这种突变的罕见性和相关研究的缺乏，SMARCA4-突变 NSCLC 患者的特征仍不十分明确。为了明确SMARCA4-突变型NSCLC的临床特征和预后因素，我们启动了本研究，以提供临床参考：我们使用了两个NSCLC-SMARCA4突变样本队列的数据：癌症基因组图谱（TCGA）数据库和本中心的临床数据。通过TCGA数据库获得了481份NSCLC-SMARCA4突变样本，用于临床特征描述。本中心收集了2020年12月至2022年7月期间连续接受治疗的224例NSCLC患者的数据。其中，26人携带SMARCA4突变，20人符合纳入研究的条件。我们分析了SMARCA4突变的临床、病理和分子特征以及预后作用。此外，我们还分析了Napsin A表达对SMARCA4突变患者预后的影响：TCGA数据库收录了480例SMARCA4-突变NSCLC患者，其中男性311例（64.8%），女性169例（35.2%），中位年龄为67岁。在我们中心的20例SMARCA4突变患者中，12例（60%）为男性，8例（40%）为女性，中位年龄为63岁。组间预后相关性分析显示，SMARCA4-突变型患者的预后明显差于SMARCA4野生型患者（SMARCA4-WT）（P=0.04）。在SMARCA4-突变组中，有Napsin A表达的患者的总生存期（OS）比没有表达的患者长（P=0.03）。Napsin A阳性组和阴性组的中位生存期分别为32个月和15个月。根据时间依赖性接收器操作曲线分析，Napsin A表达患者的一线治疗无进展生存期（PFS1）[曲线下面积（AUC）=0.748]和OS（AUC=0.586）明显更长。在SMARCA4-WT患者中未发现Napsin A的预后价值：结论：SMARCA4-突变是NSCLC患者的一个不良预后特征。结论：SMARCA4-突变是NSCLC患者的不良预后特征，Napsin A在SMARCA4-突变患者中的表达与OS延长有关。

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Clinical features and prognostic biomarkers in patients with SMARCA4-mutated non-small cell lung cancer.

Background: Patients with non-small cell lung cancer (NSCLC) carrying SMARCA4 mutations (SMARCA4-Mut) tend to have more advanced disease and a poor prognosis. However, due to the rarity of this mutation and the lack of related studies, the characteristics of SMARCA4-Mut NSCLC patients remains poorly determined. To clarify the clinical characteristics and prognostic factors of SMARCA4-Mut NSCLC, we initiated the present study to provide a clinical reference.

Methods: We used data from two cohorts of NSCLC-SMARCA4-mutated samples: The Cancer Genome Atlas (TCGA) database and our center's clinical data. The TCGA database was used to obtain 481 NSCLC-SMARCA4-Mut samples for clinical characterization. The center collected data on 224 consecutive NSCLC patients treated between December 2020 to July 2022. Among them, 26 harbored SMARCA4 mutations, and 20 were eligible for inclusion in the study. Clinical, pathological, and molecular features, as well as prognostic role of SMARCA4 mutations were analyzed. Additionally, we analyzed the prognostic impact of Napsin A expression in SMARCA4-Mut patients.

Results: The TCGA database included 480 patients with SMARCA4-Mut NSCLC, 311 males (64.8%) and 169 females (35.2%), with a median age of 67 years. Among the 20 SMARCA4-Mut patients in our center series, 12 (60%) were males and 8 (40%) females, with a median age of 63. The intergroup prognostic correlation analysis showed that SMARCA4-Mut patients had significantly worse prognosis than those the wild-type SMARCA4 (SMARCA4-WT) (P=0.04). Within the SMARCA4-Mut group, patients with Napsin A expression had longer overall survival (OS) (P=0.03) than those without expression. Median survival in the Napsin A-positive and negative groups was 32 and 15 months, respectively. According to time-dependent receiver operating curve analysis, patients with Napsin A expression had significantly longer first-line treatment progression-free survival (PFS1) [area under the curve (AUC) =0.748] and OS (AUC =0.586). No prognostic value of Napsin A was found in patients SMARCA4-WT patients.

Conclusions: SMARCA4-Mut is an adverse prognostic feature in NSCLC patients. Napsin A expression in SMARCA4-Mut patients is associated with prolonged OS.

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来源期刊

Translational lung cancer research Medicine-Oncology

CiteScore

7.20

自引率

2.50%

发文量

137

期刊介绍： Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.