Study On The Correlation Between Traditional Chinese Medical Constitution And Incidence Of Mutation In EGFR Gene In NSCLC Patients

Objective:Study on the correlation between Traditional Chinese Medical constitution and Incidence of mutation in EGFR gene in NSCLC patients.Try to find the advantage of targeted therapy from the aspects of constitution of Traditional Chinese Medical.Analyze the relationship between mutation and clinicopathological features of EGFR in NSCLC.Method:The study enrolls 220 cases of NSCLC patients which are divided into nine constitution.Getting the pathological specimens.Detect EGFR gene exon 18-21 mutation of lung cacer and normal lung tissue by ADx-ARMS method respectively.Results:1. In 220 NSCLC patients with EGFR gene mutation was detected in 117 cases of patients with lung cancer tissues, mutation rate 53.18%.2. Single factor analysis show the mutation rate of EGFR gene is relatively high in female patients,The EGFR mutation rate of female patients is 65.00% which is more than 43.33% of males,the difference between the above two is statistically significant (P=0.01).The EGFR mutation rate of adenocarcinoma patients is 60.32% which is more than 16.66% of non-adenocarcinoma patients,the difference between the two is significant (P=0.00).The EGFR mutation rate of non-smokers is 61.81% which is higher than 27.27% of smokers,the difference between the two is statistically significant (P=0.00).Multivariate analysis showed that EGFR mutation and adenocarcinom, (OR=7.284,95%CI:2.504～21.188), and non-smoker correlation (OR=0.201,95%CI:0.081～0.499),Qualitative deficiency of relative risk (OR= 0.147,,95% CI:0.027～0.792)., which is the mutation of independent factors, but the mutation is not associated with gender (P>0.05).3.The EGFR mutations occur mainly in exonl9-exon21.fifty four cases have mutations in deletion mutation of exonl 9,one cases have in deletion mutation of exon19 and exon20 T790M,for 45.45%;51 cases have mutations in exon21 L858R,2 cases have mutations in exon21 L861Q,while two case has in both of 20 T790M and 21 L858R,one case has mutations in both of 20 S768I and 21 L858Rboth accounting for 46.28%.two cases have insertion mutations in 20,one cases have mutations in 20 T790MI,there case has mutation in exon18 G719.The results show that these two forms of exon19 deletion mutation and exon21 L858R mutation account for90.085% of all mutations.4. New subtype classification adenocarcinoma with EGFR mutations exist correlation,The EGFR mutation rate of Adherent cell typeis 80.00% which is more than 51.95% of no Adherent cell type,the difference between the above two is statistically significant (P=0.024), other The pathologic types have nothing with EGFR.5. NSCLC patients with phlegm wet body EGFR mutation rate 75.68% higher than the 48.63% of the constitution, difference was statistically significant (P=0.003).Qi deficiency constitution EGFR mutation rate 42.59% to 62.65%, less than the physical difference was statistically significant (P=0.000).Yang deficiency, Yin deficiency, the great mass, gentle’ temperament, blisters, qi depression and quality of the constitution is EGFR gene mutation rate difference has no statistical significance (P>0.05).6. EGFR gene deletion and 21 loci L858R displacement distribution in the constitution of traditional Chinese medicine as follows, phlegmy wet constitution EGFR19 locus mutation rate 40.54% higher than the phlegm wet 21.86%, difference was significant (P=0.017).Qi deficiency constitution EGFR19 locus mutation rate 11.11% less than 29.52% of the constitution, the difference was significant (P=0.007).Yin deficiency constitution EGFR21 locus mutation rate 47.83% higher than the 21.83% of the constitution, the difference was significant (P=0.006).Qi deficiency constitution 21 loci EGFR mutation rate 12.96% to 28.31%, less than the physical difference was statistically significant (P=0.023).Conclusion:1 In this study NSCLC samples, factors influencing the EGFR gene mutation with lung adenocarcinoma, don’t smoke, the deficiency of quality.Multiple factors analysis showed that has little to do with sex2. EGFR mutation forms of diversity, of which 19 exons deletion and exon 21 L858R mutations as the main form.Phlegmy wet mass with 19 exons missing feature high mutation rate and Yin deficiency is qualitative in exon 21 L858R mutations characterized high, lack and deficiency of mass with 19 exons and exon 21 L858R mutation rate is low.