p53 mutation analysis for definite diagnosis of multiple primary lung carcinoma

• Published in: Cancer Vol. 94; no. 1; pp. 188 - 196
• Main Authors: van Rens, Marcel Th. M., Eijken, Erik J. E., Elbers, Johannes R. J., Lammers, Jan‐W. J., Tilanus, Marcel G. J., Slootweg, Pieter J.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York John Wiley & Sons, Inc 01-01-2002; Wiley-Liss
• Subjects: Adenocarcinoma - genetics; Adenocarcinoma - pathology; Adenocarcinoma - secondary; Biological and medical sciences; Carcinoma, Adenosquamous - genetics; Carcinoma, Adenosquamous - pathology; Carcinoma, Adenosquamous - secondary; Carcinoma, Squamous Cell - genetics; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - secondary; DNA, Neoplasm - analysis; Genes, p53; Humans; lung carcinoma; Lung Neoplasms - genetics; Lung Neoplasms - pathology; Medical sciences; metastasis; multiple primary neoplasm; Mutation; mutation analysis; Neoplasms, Multiple Primary - genetics; Neoplasms, Multiple Primary - pathology; Neoplasms, Second Primary - genetics; Neoplasms, Second Primary - pathology; nonsmall cell lung carcinoma; p53; Pneumology; Polymerase Chain Reaction; RNA, Neoplasm - analysis; Tumors of the respiratory system and mediastinum; Human; Lung disease; Multiple; Respiratory disease; Malignant tumor; Metastasis; Bronchopulmonary; TP53 Gene; Bronchus disease; Genetics; Diagnosis; Mutation; Non small cell carcinoma; Tumor suppressor gene
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.10001

BACKGROUND
The detection of a second tumor in patients with lung carcinoma raises the question whether this lesion is a metastasis or a second primary lung carcinoma. Patients cannot always be categorized satisfactorily according the criteria of multiple lung carcinoma proposed by Martini and Melamed. This may result in an inadequate treatment schedule in individual patients. Because p53 mutations can be used as clonal marker, the authors investigated whether p53 mutation analysis can differentiate between primary lung carcinomas and metastatic disease.
METHODS
Sixty‐four tumors in 31 patients with synchronous and metachronous lung tumors were investigated by p53 mutation analysis.
RESULTS
In 21 patients, the tumors showed different p53 mutations, and therefore a definite diagnosis of multiple primary lung carcinoma was made. One of these patients did not meet the criteria of Martini and Melamed. In two other patients not matching these criteria, identical mutations were demonstrated in both tumors, indicating the presence of metastatic disease. In eight patients, analysis was not conclusive or possible.
CONCLUSIONS
p53 mutation analysis can be a useful tool to confirm or rule out multiple primary lung carcinoma, and the results confirm the criteria of Martini and Melamed. However, in patients not meeting these criteria, the diagnosis of multiple lung carcinoma still has to be considered, and metastatic disease has to be ruled out. P53 mutation analysis can be helpful for this purpose. Cancer 2002;94:188–96. © 2002 American Cancer Society.
p53 mutation analysis is helpful in distinguishing pulmonary metastasis from second primary lung carcinoma.