ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
The importance of programmed death ligand 1 gene expression, epidermal growth factor receptor gene mutations and serum epidermal growth factor receptor levels in Turkish non-small cell lung cancer patients
Akif Turna1, Cem Horozoğlu2, 3, Öncü Koç Erbaşoğlu3, Şeyda Ercan3, Özlem Küçükhüseyin3, Saime Turan3, Mehmet Tolgahan Hakan3, 4, Hasan Volkan Kara1, Elvin Hekimoğlu5, Ümit Zeybek3, Ender Coşkunpınar6, Canan Cacına3, Arzu Ergen3, İlhan Yaylım3
1Department of Thoracic Surgery, Cerrahpaşa Medical Faculty, İstanbul University, İstanbul, Turkey
2Department of Medical Services and Techniques, Vocational School of Health Services, İstanbul Gelişim University, İstanbul, Turkey
3Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, İstanbul University, İstanbul, Turkey
4Department of Biology, Hitit University, Art and Science Faculty Çorum, Turkey
5National Institutes of Health, Bethesda, USA
6Department of Internal Medicine, İstanbul University, İstanbul Faculty of Medicine İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2018.15780
Background: This study aims to investigate the possible relationships between epidermal growth factor receptor gene mutations, serum epidermal growth factor receptor levels, programmed death ligand gene expression levels and the risks and survivals of resectable nonsmall cell lung cancer patients.

Methods: Deoxyribonucleic acid isolation was performed from peripheral blood samples and tumor tissues. The mutation analysis was performed for epidermal growth factor receptor. Programmed death ligand 1 gene expression levels were examined pathologically and histopathologically following the tissue tracing of 36 non-small cell lung cancer patients (29 males, 7 females; mean age 60.1 years; range, 41 to 79 years) and analyzed using real-time polymerase chain reaction. Epidermal growth factor receptor serum levels were assessed in all patients.

Results: As a result of mutation analyses in 21 patients (28.5% of all adenocarcinoma patients), epidermal growth factor receptor mutation was determined in at least one exon in six patients. In epidermal growth factor receptor mutation detected patients, programmed death ligand 1 gene expression levels were associated with lymph node metastasis (p=0.036). However, epidermal growth factor receptor mutations were not statistically significantly associated according to histopathological examination (p>0.05). Of patients carrying exon 20 (c.2303G>T) mutations, 25% had tumors with perineural invasion. There was a statistically significant association between exon 20 insertions and c.2303G>T and lymphatic invasion (p=0.02), lymph node metastasis and exon 20 insertions (p=0.03). Patients with lower serum epidermal growth factor receptor levels (<400 pg/mL) had better survival time than those with higher serum epidermal growth factor receptor levels (p=0.04).

Conclusion: Programmed death ligand 1 gene expression and epidermal growth factor receptor mutation might have a combined effect on non-small cell lung cancer. Programmed death ligand 1 gene expression in tumor pathology may also be a significant feature for tumor progression and tumorigenesis. Serum epidermal growth factor receptor levels seem to be associated with survival.

Keywords : Epidermal büyüme faktörü reseptörü; tümörlerin histopatolojisi; akciğer kanseri; programlı ölüm ligandı 1
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