Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Nov;8(7):2564-2569.
doi: 10.21037/tcr.2019.10.37.

A comparison of MASS-PCR and ARMS-PCR for the detection of lung cancer gene mutation

Ling Cai #  1   2 , Weidong Wang #  3 , Fang Wang  1   4 , Rusi Zhang  1   5 , Lanjun Zhang  1   5 , Huiwei Qi  6 , Weiquan Gu  7 , Ningning Zhou  1   8
Affiliations

A comparison of MASS-PCR and ARMS-PCR for the detection of lung cancer gene mutation

Ling Cai et al. Transl Cancer Res. 2019 Nov.

Abstract

Background: Targeted therapy has been proven to be effective in lung cancer patients with specific driver gene mutations. At present, Sanger sequencing is still the gold standard in clinical practice to detect mutation, and amplification refractory mutation system PCR (ARMS-PCR) has become widely used due to its higher sensitivity and less limitation compared with Sanger sequencing. Mutation-selected amplification specific system PCR (MASS-PCR) is a novel gene detection technique with high specificity and sensitivity. This study aimed to compare the accuracy and sensitivity of ARMS-PCR and MASS-PCR and purposed to make an alternative choice in gene mutation detection in lung cancer.

Method: A total of 293 formalin-fixed paraffin-embedded (FFPE) tissues were collected from 293 patients with lung cancer from 2017 to 2018. The sample mutation statuses were evaluated by ARMS-PCR and MASS-PCR. Sanger sequencing was also conducted to confirm the results further. The consistency of ARMS-PCR and MASS-PCR were analyzed, and receiver operating characteristic (ROC) curve was drawn to assess the sensitivity and specificity of MASS-PCR.

Results: The consistency rate between the MASS-PCR and Sanger sequencing (kappa value =0.929) was higher than that between the MASS-PCR and ARMS-PCR (kappa value =0.821). There were 20 samples had inconsistent results among the three assays. For these samples, 11 positive samples were verified by the MASS-PCR and Sanger sequencing. Besides, 3 negative samples in Sanger sequencing were detected to be positive in MASS-PCR and ARMS-PCR. The ROC area under the curve (AUC) of assay panels was 0.930 referring to ARMS-PCR, and 0.967 as Sanger sequencing was referred to.

Conclusions: Our study demonstrated a higher accuracy and sensitivity of MASS-PCR than ARMS-PCR. Therefore, MASS-PCR could be used in clinical practice to detect gene mutations in lung cancer patients.

Keywords: Mutation-selected amplification specific system PCR (MASS-PCR); amplification refractory mutation system PCR (ARMS-PCR); lung cancer; mutation detection.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tcr.2019.10.37). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Inconsistent detection results in patients. Patients detected to carry common mutations are represented with black blocks. Otherwise, they are represented by white blocks. MASS-PCR, mutation-selected amplification specific system PCR; ARMS-PCR, amplification refractory mutation system PCR.
Figure 2
Figure 2
ROC curves of MASS-PCR referring to ARMS-PCR and Sanger sequencing. (A) ROC curve of MASS-PCR referring to ARMS-PCR, and the AUC was 0.930 (95% CI: 0.895–0.956); (B) ROC curve of MASS-PCR referring to Sanger sequencing, and the AUC was 0.967 (95% CI: 0.940–0.984). ROC, receiver operating characteristic; MASS-PCR, mutation-selected amplification specific system PCR; ARMS-PCR, amplification refractory mutation system PCR; AUC, area under the curve; CI, confidence interval.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Ettinger DS, Wood DE, Aisner DL, et al. Non-small cell lung cancer, version 5.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2017;15:504-35. 10.6004/jnccn.2017.0050 - DOI - PubMed
    1. Hirsch FR, Scagliotti GV, Mulshine JL, et al. Lung cancer: current therapies and new targeted treatments. Lancet 2017;389:299-311. 10.1016/S0140-6736(16)30958-8 - DOI - PubMed
    1. Li T, Kung HJ, Mack PC, et al. Genotyping and genomic profiling of non-small-cell lung cancer: implications for current and future therapies. J Clin Oncol 2013;31:1039-49. 10.1200/JCO.2012.45.3753 - DOI - PMC - PubMed
    1. Ortiz-Cuaran S, Scheffler M, Plenker D, et al. Heterogeneous mechanisms of primary and acquired resistance to third-generation EGFR inhibitors. Clin Cancer Res 2016;22:4837-47. 10.1158/1078-0432.CCR-15-1915 - DOI - PubMed
    1. Osmani L, Askin F, Gabrielson E, et al. Current WHO guidelines and the critical role of immunohistochemical markers in the subclassification of non-small cell lung carcinoma (NSCLC): moving from targeted therapy to immunotherapy. Semin Cancer Biol 2018;52:103-9. 10.1016/j.semcancer.2017.11.019 - DOI - PMC - PubMed