Necessity of Microdissecting Different Tumor Components in Pulmonary Tumor Pyrosequencing

Figure 1

Six pyrograms, panels (a, b, c, d, e, and f), are present. The -axis represents pyrosequencing dispensing order. The -axis represents peak height. Panel (a) shows a pyrogram of wild type KRAS codons 12 and 13. Panel (b) shows a pyrogram from the whole tumor of an adenocarcinoma with neuroendocrine differentiation. The pyrogram peak pattern is different from a wild type pattern, but the pattern cannot match any KRAS mutation patterns. Panel (c) shows a pyrogram from the adenocarcinoma component that is shown in Figure 2(a), indicating KRAS G12C mutation. Three small peaks (indicated by black arrows) reflect the contamination of adenocarcinoma by neuroendocrine component due to imperfect microdissection. Panel (d) shows a pyrogram from the neuroendocrine component that is shown in Figure 2(b), indicating KRAS G12D mutation. Panel (e) shows a pyrogram from a tumor nodule with features of minimally invasive adenocarcinoma that is shown in Figure 2(d), indicating a wild type BRAF. Panel (f) shows a pyrogram from an invasive adenocarcinoma, solid predominant, poorly differentiated carcinoma nodule, which is shown in Figure 2(c), indicating BRAF V600E mutation.

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