Are Bronchioloalveolar Carcinoma and Early Invasive Adenocarcinoma More Frequent in Elderly Caucasians Than in Young Asian Women?
Ann E Walts, Amin Riley-Portuges, Andy Pao, Tam Truong, Lara Baden, Jean Lopategui, Alberto M Marchevsky. Cedars-Sinai Medical Center, Los Angeles, CA
Background: Bronchioloalveolar carcinoma/adenocarcinoma-in-situ (BAC) and early invasive adenocarcinoma (BAC with <5 mm of invasion;EIA) have generally been described in Asian, never-smoking women <50 years of age. However, it has been our impression that most BAC and EIA patients in our practice are elderly and similar in age and gender ratio to patients with pulmonary mixed adenocarcinoma (MAC) (mean age 71 yrs; median age 70 yrs; 60% female; approximately 90% Caucasian).
Design: 77 consecutive single pulmonary lesions diagnosed as BAC (27) and EIA (50) were retrieved from among 1081 pulmonary adenocarcinomas excised at our hospital during a 5 year period. After slides were reviewed and diagnoses confirmed, EGFR and KRAS mutation analysis was performed on DNA extracted from each formalin fixed paraffin embedded tumor. Age, gender ratio, smoking history, tumor size, and frequency of EGFR (deletion in exon 19 and L858R mutation in exon 21) and KRAS mutations were tabulated and compared using the chi-square test.
Results: Results are shown in the table below.
|Age Mean/Range||Caucasian||Smoker||Female||Median Size||EGFR mutation||KRAS mutation|
|BAC||71/55-89 yrs||92.6%||69.2%||59%||1.1 cm||34.6%||7.7%|
|del in EX19 (19.2%)|
|L858R in EX21 (15.4%)|
|EIA||72/53-89 yrs||90%||65.2%||66%||1.6 cm||19.2%||20.5%|
|del in EX19 (10.6%)|
|L858R in EX21 (8.5%)|