Analysis of mutational and clinicopathologic characteristics of lung adenocarcinoma with clear cell component

INTRODUCTION: Lung adenocarcinoma with clear cell component is extremely rare and the cases reported in literature remain scarce. The biological behaviors, clinicopathologic characteristics, mutational status and prognosis of lung adenocarcinoma with clear cell component are still uncertain. METHODS: Thirty-eight lung adenocarcinomas with clear cell component and 1659 lung adenocarcinomas were subjected to the study. All the corresponding clinicopathologic data, the distributions of relapse-free survival (RFS) and overall survival (OS), and the status of gene mutations were investigated. RESULTS: Of 1697 adenocarcinomas, 38 (2.2%) had clear cell component. Fifty percent of adenocarcinomas with clear cell component (11/22) harbored EGFR mutation, 41 percent (9/22) harbored KRAS mutation and 5 percent (1/22) harbored AKT1 mutation. Univariable analysis revealed that sex, age, tumor stage, tumor size, nodal stage and pathology were all significant predictors of RFS and OS while the tumor size and nodal stage were still significant predictors in multivariable analysis. There were significantly differences in RFS and OS for lung adenocarcinomas with clear cell component compared with those lung adenocarcinomas. CONCLUSIONS: Lung adenocarcinoma with clear cell component is a rare, malignant tumor with poor prognosis and displays more frequent EGFR and KRAS mutations.