Cerebrospinal Fluid TP53 Gene Mutation In Patients With Lung Cancer Associated Meningitis And Its Clinical Observation

Objective: The aim of this study was to investigate the clinical features,cerebrospinal fluid leukocyte,cerebrospinal fluid biochemistry,KPS and overall survival of patients with TP53 gene mutation in lung cancer associated meningitis,to raise the awareness of clinicians about the role of TP53 gene mutations in lung cancer associated meningitis.Methods:A retrospective analysis was performed on 35 patients diagnosed with lung cancer associated meningitis at Second Hospital of Hebei Medical University from December 2015 to December 2018.All patients underwent the next-generation sequencing of cerebrospinal fluid,and TP53 gene was found to be mutant or wild type,including 23 patients with TP53 mutant type and 12 patients with TP53 wild type.The clinical characteristics,CSF leukocyte,protein,glucose,chloride,KPS and overall survival were observed between the two groups.Results:In terms of clinical characteristics,headache,nausea and vomiting were the main symptoms in both the TP53 mutant group and the wild type group.The incidence of headache and nausea and vomiting in the TP53 mutant group was 86.9% and 60.9%,respectively,and the incidence of headache and nausea and vomiting in the TP53 wild type group was 58.3% and 41.7%,respectively.There were no significant differences in CSF pressure,leukocyte,biochemical and KPS between the two groups.The average time from diagnosis of lung cancer to diagnosis of lung cancer associated meningitis in the TP53 mutant group was significantly shorter than that in the TP53 wild type group(5.79 months vs.25.5 months).The median survival time of patients in the TP53 mutant group from lung cancer diagnosis to the observation endpoint was 19.77 months,while the median survival time of patients in the TP53 wild type group from lung cancer diagnosis to the observation endpoint was 88.73 months,the difference was statistically significant(P=0.043).Conclusions:1 Adenocarcinoma is the main primary cancer in patients with lung cancer associated meningitis,and subacute way is the most common,and middle-aged and elderly patients are the most common patients.2 TP53 gene mutation can be detected in cerebrospinal fluid of patients with lung cancer associated meningitis,with a mutation rate of 65.7%.3 The average time of primary metastasis to meningitis was shorter in patients with lung cancer associated meningitis with TP53 gene mutation.4 From the diagnosis of lung cancer to the end point of observation,the median survival time of TP53 mutant group was shorter than that of TP53 wild type group.