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DOI: 10.1055/s-0031-1281789
© Georg Thieme Verlag KG Stuttgart · New York
EGFR-Mutationsanalyse bei immunhistochemischem Nachweis eines pulmonalen Plattenepithelkarzinoms
EGFR Mutation Analysis after Immunohistochemical Proof of a Pulmonary Squamous Cell CarcinomaPublication History
Publication Date:
02 December 2011 (online)

Zusammenfassung
Vor dem Hintergrund einer wachsenden prognostischen wie auch prädiktiven Bedeutung der Histologie und einer eher rückläufigen Rate von Resektionen kommt der Biopsie-gestützten pathologischen Befundung zunehmende Bedeutung zu. Mittels immunhistochemischer Zusatzuntersuchungen lässt sich der histologische Befund absichern. Die EGFR-Mutationsanalyse erlaubt zudem, das molekularpathologische Profil von Patienten mit Bronchialkarzinom besser zu charakterisieren und die Patienten zu selektieren, die in hohem Maße von einer Therapie mit einem EGFR-Tyrosinkinase-Inhibitor profitieren. Die Einbeziehung solcher prognostischer wie prädiktiver Faktoren erfordert vom behandelnden Onkologen eine eingehende Kommunikation und Kooperation mit dem Pathologen, der die histologische Befundsicherung einschließlich aller Unsicherheiten umfassend genau dokumentieren sollte.
Abstract
In face of the growing prognostic and predictive relevance of tumor histology and a decreasing rate of tumor resections the biopsy-based pathological tumor diagnosis gains importance. Additional immunohistochemical tests are helpful to confirm a supposed histology. EGFR mutation analysis allows better to identify patients’ molecular pathology profile and to select those patients which are likely to benefit from a therapy with EGFR tyrosine kinase inhibitors. The inclusion of additional prognostic and predictive factors requires intensive communication and cooperation between the medical oncologist and the pathologist, who should carefully document the whole histological diagnosis pattern, inclusive of potential uncertainties.
Schlüsselwörter
NSCLC - Plattenepithelkarzinom - immunhistochemische Befundsicherung - EGFR-Mutationsanalyse
Key words
NSCLC - squamous cell carcinoma - immunhistochemical proof - EGFR mutation analysis
Literatur
- 1
Beasley M B.
Immunohistochemistry of Pulmonary and Pleural Neoplasia.
Arch Pathol Lab Med.
2008;
132
1062-1072
MissingFormLabel
- 2
Hirsch F R, Spreafico A, Novello S et al.
The Prognostic and Predictive Role of Histology in Advanced Non-small Cell Lung Cancer.
J Thor Oncol.
2008;
3
1468-1481
MissingFormLabel
- 3
Syrigos K N, Vansteenkiste J, Parikh P et al.
Prognostic and predictive factors in a randomized phase III trial comparing cisplatin-pemetrexed
versus cisplatin-gemcitabine in advanced non-small cell lung cancer.
Ann Oncol.
2010;
21
556-561
MissingFormLabel
- 4
Ciuleanu T, Brodowicz T, Zielinski C et al.
Maintenance pemetrexed plus best supportive care versus placebo plus best supportive
care for non-small cell lung cancer: a randomized, double-blind phase III study.
Lancet.
2009;
374
1432-1440
MissingFormLabel
- 5
Mok T S, Wu Y L, Throngprasert S et al.
Gefitinib or Carboplatin-Paclitaxel in Pulmonary Adenocarcinoma.
New Engl J Med.
2009;
361
947-957
MissingFormLabel
- 6
Shepherd F, Pereira J R, Ciuleanu T et al.
Erlotinib in Previously Treated Non-Small-Cell Lung Cancer.
N Engl J Med.
2005;
353
123-132
MissingFormLabel
- 7
Marchetti A, Martella C, Felicioni L et al.
EGFR Mutations in Non-Small-Cell Lung Cancer: Analysis of a Large Series of Cases
and Development of a Rapid and Sensitive Method for Diagnostic Screening with Potential
Implications on Pharmacologic Treatment.
J Clin Oncol.
2005;
23
857-865
MissingFormLabel
- 8
Tapia C, Savic S, Bihl M et al.
EGFR-Mutationsanalyse beim nicht-kleinzelligen Lungenkarzinom.
Der Pathologe.
2009;
30
384-392
MissingFormLabel
- 9
Wacker B, Nagrani T, Weinberg J et al.
Correlation between Development of Rash and Efficacy in Patients Treated with the
Epidermal rowth Factor Receptor Tyrosine Kinase Inhibitor Erlotinib in Two Large Phase
III Studies.
Clin Cancer Res.
2007;
13
3913-3921
MissingFormLabel
- 10
Segeaert S, Van Cutsem E.
Clinical signs, pathophysiology, and management of skin toxicity during therapy with
epidermal growth factor receptor inhibitors.
Ann Oncol.
2005;
16
1425-1433
MissingFormLabel
- 11
Tufman A, Huber R M.
Biological markers in lung cancer: A clinician’s perspective.
Cancer Biomark.
2010;
6
123-135
MissingFormLabel
- 12
Dietel M, Schirmacher P.
Molekularpathologische Analyse beim metastasierten NSCLC.
Der Onkologe.
2010;
16
63-66
MissingFormLabel
- 13
Maemondo M, Inoue A, Kobayashi K et al.
Gefitinib or Chemotherapy for Non-Small Cell Lung Cancer with Mutated EGFR.
N Engl J Med.
2010;
362
2380-2388
MissingFormLabel
- 14
Rosell R, Moran T, Queralt C et al.
Screening for Epidermal Growth Factor Receptor Mutations in Lung Cancer.
N Engl J Med.
2009;
361
958-967
MissingFormLabel
Volker Kächele
Hämato-Onkologische Schwerpunkt-Praxis Ulm
Magirushof 23
89077 Ulm
Email: Volker.kaechele@gmx.de