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Background  Molecular testing of lung adenocarcinoma for oncogenic driver mutations has become standard in pathology practice. The aim of the study was to analyze the  EGFR ,  KRAS ,  ALK ,  RET ,  ROS1 ,  BRAF ,  ERBB2 ,  MET  and  PIK3CA  mutational status in a representative cohort of Swiss patients with lung adenocarcinoma and to correlate the mutational status with clinicopathological patient characteristics.    Methods  All patients who underwent molecular testing of newly diagnosed lung adenocarcinoma during a 4-year period (2014–2018) were included. Molecular analyses were performed with Sanger sequencing ( n  = 158) and next generation sequencing ( n  = 311).  ALK ,  ROS1  and  RET  fusion gene analyses were also performed with fluorescence in situ hybridization and immunohistochemistry/immunocytochemistry. Demographic and clinical data were obtained from the medical records.    Results  Of 469 patients with informative  EGFR  mutation analyses, 90 (19.2%) had  EGFR  mutations.  KRAS  mutations were present in 33.9% of the patients, while 6.0% of patients showed  ALK  rearrangement.  BRAF ,  ERBB2 ,  MET  and  PIK3CA  mutations and  ROS1  and  RET  rearrangements were found in 2.6%, 1.9%, 1.9%, 1.5%, 1.7% and 0.8% of the patients, respectively.  EGFR  mutation was significantly associated with female gender and never smoking status.  ALK  translocations were more frequent in never smokers, while  KRAS  mutations were more commonly found in ever smokers. The association between  KRAS  mutational status and female gender was statistically significant only on multivariate analysis after adjusting for smoking.    Conclusion  The  EGFR  mutation rate in the current study is among the higher previously reported mutation rates, while the frequencies of  KRAS ,  BRAF ,  ERBB2  and  PIK3CA  mutations and  ALK ,  ROS1  and  RET  rearrangements are similar to the results of previous reports.  EGFR  and  KRAS  mutations were significantly associated with gender and smoking.  ALK  rearrangements showed a significant association with smoking status alone.    Electronic supplementary material  The online version of this article (10.1186/s13000-019-0789-1) contains supplementary material, which is available to authorized users.

diagnostic pathology

Analysis of the frequency of oncogenic driver mutations and correlation with clinicopathological characteristics in patients with lung adenocarcinoma from Northeastern Switzerland