The Predictive Value Of The Clinicopathological Features And Thyroid Transcription Factor-1 On The Epidermal Growth Factor Receptor Mutation And The Prognosis In Non-smallcell Lung Cancer

Objective:To study the value of clinicopathological features and thyroid transcription factor 1(TTF-1)in predicting the mutation status of epidermal growth factor receptor(EGFR)gene in patients with non-small cell lung cancer(NSCLC)and the relationship between these factors and the prognosis of the patients.Methods:Mutation status of exons 18,19,20and21 in EGFR,and expression of TTF-1 protein in 283 cases of NSCLC were analyzed by using amplification refractory mutation system(ARMS)and immunohistochemical method.The correlation of EGFR mutations with the clinicopathological features and TTF-1 exepression were studied to explore the value of them in the prediction of EGFR mutations.At the same time,the factors that affect the prognosis of the patients were analyzed by Kaplan-Meier survival analysis and LogRank analysis.Results:Among 283 cases of NSCLC,the rate of EGFR gene mutation was 30%(85/283),including 3 cases with double mutations(exon 18 and exon 20 double mutations in one case,exon 19 and exon 21 double mutations in one case,exon 20 and exon 21 double mutations in one case);The EGFR gene mutations status were associated with gender(P<0.001),histological type(P<0.001),history of smoking(P<0.001),and expression of TTF-1(P<0.001),but not related to age(P=0.785)and tumor location(P=0.138);The combination of factors with high mutation rates(women,adenocarcinoma,no smoking,and TTF-1 positivity)made the positive predictive value of EGFR mutations reach57.6%.And the combination of factors with low mutation rates(male,nonadenocarcinoma,smoking history,TTF-1 negative)made the EGFR negative predictive value up to 90.3%.It was showed by Survival analysis that tumor size(P=0.005),N stage(P=0.011),M stage(P=0.001),clinical stage(P=0.003),TTF-1expression(P=0.044)and EGFR mutation(P=0.003)were associated with overall survival.Conclusion:The combination of clinicopathological features and TTF-1 in patients with NSCLC can not only predict thestatus of EGFR mutation but also predict the prognosis of patients,which can provide a useful reference for clinical treatment decision-making.