
DETECTING EGFR MUTATIONS IN PATIENTS
WITH NON-SMALL CELL LUNG CANCER Hammoudeh ZA, Antonova O, Staneva R, Nikolova D, Kyuchukov Y,
Penev A, Mintchev T, Koleva V, Hadjidekova S, Toncheva D *Corresponding Author: Zora A. Hammoudeh, Molecular Biologist, Department of Medical Genetics, Medical University Sofia,
2 Zdrave Str., 1431 Sofia, Bulgaria. Tel: +359-2-917-2735. Mobile: +359-88-943-0505. E-mail: zorahammoudeh@yahoo.com page: 13
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MATERIALS AND METHODS
Tumor samples from 551 Bulgarian patients diagnosed
with NSCLC have been collected for the last 5
years. The patients were aged between 24 and 84 years old
and the average age was 63. The gender ratio in the tested
group was 407 (73.9%) males and 144 females (26.1%).
All procedures were supervised and approved by the hospital’s
Ethics Committee. For examination of the samples,
the patients provided a signed written informed consent.
DNA was extracted from FFPE NSCLC samples from
primary tumors by QIAamp DNA FFPE Tissue Kit (Qiagen
Ltd.) for genomic DNA purification. The concentrations
of the DNA samples were measured by NanoDrop
Lite spectrophotometer system (Thermo Fisher Scientific,
Waltham, MA, USA).
The therascreen EGFR RGQ PCR Kit (Qiagen Ltd.)
was custom-made for detecting 29 somatic mutations in exons 18-21 of the EGFR gene using a RT-PCR technology.
The amplification reaction was done on the Rotor-Gene
Q instrument (Qiagen Ltd.). For detecting the mutations
with RT-PCR, the assay used two technologies, ARMS and
Scorpions (Qiagen Ltd.). Mutation-specific amplification
was performed using the ARMS technique, meanwhile
detection of amplification was performed using Scorpions
PCR primers linked to a probe. After completing the PCR
run, each DNA sample was analyzed for the presence of
EGFR gene mutations, or not, by Rotor-Gene Q Series
(Qiagen Ltd.). If there was amplification on one or more
mutation reaction in the sample, the difference between
the mutation cycle threshold (CT) and control (CT) from
the same sample was used to calculate CT values. Then we
compare the CT value for the sample with the cutoff point
for the assay in a table according to the manufacturer’s
guideline (Qiagen Ltd.).
We used the χ2 tests to evaluate the association between
EGFR gene mutations and clinicopathological
features, such as gender, smoking status and histological
type. The statistical analysis was performed between the
positive EGFR patient’s groups, divided into males vs.
females, smokers vs. non smokers and adenocarcinomas
and other histological types (squamous cell carcinoma
and large cell carcinoma). All the statistical analyses were
performed using the R Core Team (2013) software (http://
www.R-project.org/.) The results were considered statistically
significant at a p value of less than 0.05.
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