The Impact of Cigarette Smoking on the Frequency of and Qualitative Differences in KRAS Mutations in Korean Patients with Lung Adenocarcinoma.
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3349/ymj.2013.54.4.865
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Hye Ryun KIM
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Jung Ryun AHN
			        		
			        		;
		        		
		        		
		        		
			        		Jin Gu LEE
			        		
			        		;
		        		
		        		
		        		
			        		Doo Hee BANG
			        		
			        		;
		        		
		        		
		        		
			        		Sang Jun HA
			        		
			        		;
		        		
		        		
		        		
			        		Yun Kyoung HONG
			        		
			        		;
		        		
		        		
		        		
			        		Sun Mi KIM
			        		
			        		;
		        		
		        		
		        		
			        		Ki Chang NAM
			        		
			        		;
		        		
		        		
		        		
			        		Sun Young RHA
			        		
			        		;
		        		
		        		
		        		
			        		Ross A SOO
			        		
			        		;
		        		
		        		
		        		
			        		Gregory J RIELY
			        		
			        		;
		        		
		        		
		        		
			        		Joo Hang KIM
			        		
			        		;
		        		
		        		
		        		
			        		Byoung Chul CHO
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea. cbc1971@yuhs.ac
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
 
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		EGFR;
			        		
			        		
			        		
				        		KRAS;
			        		
			        		
			        		
				        		pulmonary adenocarcinoma;
			        		
			        		
			        		
				        		cigarette smoking;
			        		
			        		
			        		
				        		EGFR-tyrosine kinase inhibitors
			        		
			        		
	        			
        			
        		
 
        	
            
            	- MeSH:
            	
	        			
	        				
	        				
				        		
					        		Adenocarcinoma/drug therapy/etiology/*genetics/pathology;
				        		
			        		
				        		
					        		Adult;
				        		
			        		
				        		
					        		Aged;
				        		
			        		
				        		
					        		Aged, 80 and over;
				        		
			        		
				        		
					        		Asian Continental Ancestry Group/genetics;
				        		
			        		
				        		
					        		Female;
				        		
			        		
				        		
					        		Humans;
				        		
			        		
				        		
					        		Incidence;
				        		
			        		
				        		
					        		Lung Neoplasms/drug therapy/etiology/*genetics/pathology;
				        		
			        		
				        		
					        		Male;
				        		
			        		
				        		
					        		Middle Aged;
				        		
			        		
				        		
					        		*Mutation;
				        		
			        		
				        		
					        		Mutation Rate;
				        		
			        		
				        		
					        		Proportional Hazards Models;
				        		
			        		
				        		
					        		Proto-Oncogene Proteins/*genetics;
				        		
			        		
				        		
					        		Receptor, Epidermal Growth Factor/antagonists & inhibitors/genetics;
				        		
			        		
				        		
					        		Smoking/adverse effects/*genetics;
				        		
			        		
				        		
					        		Treatment Outcome;
				        		
			        		
				        		
					        		ras Proteins/*genetics
				        		
			        		
	        			
	        			
            	
            	
 
            
            
            	- From:Yonsei Medical Journal
	            		
	            		 2013;54(4):865-874
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	PURPOSE: This study was designed to determine the relationship of cigarette smoking to the frequency and qualitative differences among KRAS mutations in lung adenocarcinomas from Korean patients. MATERIALS AND METHODS: Detailed smoking histories were obtained from 200 consecutively enrolled patients with lung adenocarcinoma according to a standard protocol. EGFR (exons 18 to 21) and KRAS (codons 12/13) mutations were determined via direct-sequencing. RESULTS: The incidence of KRAS mutations was 8% (16 of 200) in patients with lung adenocarcinoma. KRAS mutations were found in 5.8% (7 of 120) of tumors from never-smokers, 15% (6 of 40) from former-smokers, and 7.5% (3 of 40) from current-smokers. The frequency of KRAS mutations did not differ significantly according to smoking history (p=0.435). Never-smokers were significantly more likely than former or current smokers to have a transition mutation (G-->A or C-->T) rather than a transversion mutation (G-->T or G-->C) that is known to be smoking-related (p=0.011). In a Cox regression model, the adjusted hazard ratios for the risk of progression with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) were 0.24 (95% CI, 0.14-0.42; p<0.001) for the EGFR mutation and 1.27 (95% CI, 0.58-2.79; p=0.537) for the KRAS mutation. CONCLUSION: Cigarette smoking did not influence the frequency of KRAS mutations in lung adenocarcinomas in Korean patients, but influenced qualitative differences in the KRAS mutations.