| BackgroundIn recent years,the targeted treatment of lung cancer,especially non-small cell lung cancer(NSCLC),has made great progress,entered the stage of "individualized treatment",and significantly prolonged the survival time of patients with middle and late stage lung cancer.In recent years,the relationship between EGFR gene and small molecule tyrosine kinase inhibitors(TKIs)targeting drugs has become a research hotspot.TKIs is widely used in clinical treatment for NSCLC patients with EGFR gene mutation positive,which has the advantages of small side effects and good patient compliance.EGFR gene detection plays an increasingly important role.According to previous studies,we found that there is a relationship between EGFR gene mutation and the clinicopathological characteristics of patients.On this basis,we selected patients with stage Ⅰ-Ⅲ a surgical resection of lung adenocarcinoma as samples to further explore the relationship between EGFR gene mutation exon and mutation type and clinicopathological characteristics of patients with early lung adenocarcinoma,in order to predict the mutation state of EGFR gene and guide the target Provide basis for treatment.ObjectiveThe clinical data of 278 patients with lung adenocarcinoma diagnosed and treated surgically in the First Affiliated Hospital of Zhengzhou University from January 2016 to March 2019 were analyzed to explore the correlation between their clinicopathological characteristics and EGFR mutation exons and mutation types.MethodsA retrospective analysis was made of 278 patients with lung adenocarcinoma diagnosed and treated in the thoracic surgery department of the First Affiliated Hospital of Zhengzhou University from January 2016 to March 2019.The EGFR gene in the resected specimens was detected by fluorescence PCR,and the main histological types(wall growth type,acinar type,papillary type,microemulsion head type,solid type)were confirmed according to the new classification method of lung adenocarcinoma.The differences of mutation rate,exon and type of EGFR gene in sex,age,smoking history,differentiation degree,pathological stage,tumor diameter and histological subtype were compared.ResultsAmong 278 patients with lung adenocarcinoma,121 were male and 157 were female.The age range was 31-84 years,the average age was 58.7 years,the median age was 60,the median tumor diameter was 2.36cm,and the mutation rate of EGFR gene was 61.9%(172/278).Sex,smoking status,tumor diameter,differentiation degree and histological subtype were significant for EGFR gene mutation(P<0.05).The results of multiple logistic regression analysis showed that middle differentiation and invasive adenocarcinoma were independent factors of EGFR gene mutation in patients with lung adenocarcinoma(P<0.05).Among 255 cases of invasive adenocarcinoma,24 were solid type,32 were adherent type,174 were acinar type,18 were papillary type and 7 were micropapillary type.The mutation rate of EGFR gene in acinar type was the highest,while that in adherent growth type and papillary type was higher than that in solid type(P<0.05).The mutation rate of exon 19 and deletion of EGFR gene in smoking patients with lung adenocarcinoma was higher than that of exon 21 and missense mutation(P<0.05).The mutation rate of exon 19 in patients with stage Ⅲ a was higher than that of exon 21.(P<0.05).ConclusionEGFR gene mutations were more common in female,nonsmoking,medium/high differentiation,tumor diameter ≤ 2.4cm,and invasive lung adenocarcinoma patients(P<0.05).There was no significant correlation with pathological stage and age.Middle differentiation and histological subtypes are independent factors affecting EGFR gene mutation.Smoking status and pathological stage were significant for mutations of exon 19 and exon 21 of EGFR.Smoking status also had statistical significance for EGFR gene mutation type. |
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