Air pollution-related lung cancer has been considered as an exacerbating public health problem worldwide, particularly in developing countries. Xuanwei and Fuyuan County in Yunnan, China, regions with severely polluted air and exceptionally high lung cancer rates, are considered as good models to study air pollution-related lung cancer. The objective of the study was to establish a simple and sensitive test to define the status of clinically significant oncogenes in air pollution-related lung cancer.
This study investigated the expression and mutation of HER2, and fusion gene EML4-ALK, CD74-ROS1 prevalence in lung cancer patients by reverse transcription PCR (RT-PCR) and DNA sequencing.
Of the 82 patients with non-small cell lung cancer, 20.7% (17/82) exhibited HER2 up-regulation, and 1.2% (1/82) harbored HER2 insertion at exon 20. HER2 overexpression was not associated with air pollution levels and smoking status; 6.1% (5/82) showed ALK gene rearrangements, two belonged to EML4-E2 + ALK-E20 and three were EML4-E13 + ALK-E20; 3.6% (3/82) carried the CD74-ROS1 fusion gene (CD74-E6 + ROS1-E34). EML4-ALK fusion was found associated with smoking or a heavily polluted region, while CD74-ROS1 fusion occurred more frequently in non-smokers and in low polluted areas.
The screening of HER2 overexpression and EML4-ALK fusion is helpful to guide treatment of air pollution-related lung cancer; the proposed RT-PCR-based test could be a useful tool in clinical applications to screen these genetic changes.
Clinical trial identification
Legal entity responsible for the study
Natural Science Foundation of China (grant number 81272617)
All authors have declared no conflicts of interest.