analysis.K-ras mutations were found in 14 (25%) cases of adenocarcinoma; 13 were detected by direct sequencing and the remaining mutation was only detected by pyrosequencing analysis.Detected mutations were G12C (eight cases), G12V (four cases), G12D (one case) and G12A (the case identified by pyrosequencing).This group comprised eight females and six males, of whom 11 were current smokers, two were former smokers and one had never smoked.Two had stage II, seven had stage III and five had stage IV disease.None of the patients showed both EGFR and K-ras mutations.In five patients with gene mutations, two EGFR and three Kras, we performed the analysis on a scalar number of cells isolated from cytologic samples by pyrosequencing (from 100 to 20 cells) to verify whether mutations could be detected in a small number of cells.EGFR and K-ras mutations were detectable in samples with as few as 20 cells.In 32 patients for whom cell blocks (20 samples) and/or histologic material (19 samples) were available, comparative analyses confirmed results obtained from cytologic smears (table 1).In conclusion, we demonstrated that cytologic specimens from archival material are adequate for EGFR and K-ras molecular analyses and that results are concordant with those obtained from histologic material.We also showed that very few cells are required for mutation detection, thus enabling molecular analyses to be performed on patients for whom very little biological material is available, and leaving open the possibility of using different methodologies to analyse other potentially interesting molecular targets.
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Frank et al. (2012) studied this question.
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