Correlation Analysis Of Acquired EGFR T790M Mutation In Advanced Lung Adenocarcinoma

purposeTo analyze t1 he correlation between acquired T790M mutation and general clinical features in advanced lung adenocarcinoma.To explore the basic rules and characteristics of lung adenocarcinoma patients who are prone to acquired T790M mutations,and provide guidance for clinical treatment.methodCollected and retrospectively analyzed the general clinical data of 119 patients with advanced lung adenocarcinoma treated with EGFR-TKIs in our hospital from January 2010 to September 2020.Chi-square test was used to determine the general conditions of the patients(gender,age).Smoking history,mutation type and taking targeted drugs),initial serological status(tumor markers CEA,CYFRA211),initial metastasis site(bone,brain)and acquired T790M mutation status for correlation analysis,the theoretical frequency(T)<5 patients choose Fisher’s exact probability method,and further conduct multivariate binary Logistic analysis for the above-mentioned correlated factors.The statistical result is P<0.05 as meaningful.resultIn the whole group of patients,61 cases were positive for T790M gene mutation,accounting for 51%,and 58 cases were negative for T790M mutation,accounting for 49%.The results of correlation analysis showed that T790M mutations were higher in patients younger than 60 years old than patients older than 60 years(52.5%,50%,P=0.781);smoking patients had higher T790M mutations than non-smokers(54.8%,50%,P =0.643);patients without hypertension had a higher T790M mutation rate than hypertension patients(55.8%,43%,P=0.176);patients without diabetes had a higher T790M mutation rate than diabetic patients(52.3%,41.7%,P=0.483);baseline brain metastasis,bone metastasis,N0-1 lymph node metastasis and N2-3 lymph node metastasis,T1-3 stage,T4 stage,M1 stage,ECOG0-1,ECOG2-4 patients with T790M mutation rate is divided into 51.5%(50/97),50%(16/32),75%(15/20),46.5%(46/99),46.5%(46/99),49.4%(42/85),49.4%(42 /85),49.4%(42/85),100%(4/4);the mutation rates of T790M in the targeted therapy and targeted combined chemotherapy groups were 49.5%(45/91)and 57.1%(16/28),to further subdivide the targeted treatment plan,theprobability of T790M mutation in the Icotinib group and non-Icotinib group is 49.5%(45/91),66%(31/47),19 gene mutations.The probability of T790M mutation with 21 gene mutation is 46.4%(32/69),58%(29/50).The results of univariate analysis show: gender,age,smoking history,hypertension,type 2 diabetes,brain metastasis,bone metastasis.There is no correlation between,T stage,M stage,treatment plan,gene mutation type,and T790M gene mutation.ECOG score,lymph node metastasis,and Icotinib treatment are related to T790M mutation(all P less than 0.05).By T test,it can be found that there was no correlation between baseline Cyfra21-1,CEA and T790M mutation(P values were 0.303,0314,respectively).Multivariate analysis showed that only lymph node metastasis was associated with Icotinib treatment and T790M mutation.The longer the PFS1 in patients with lung adenocarcinoma,the greater the possibility of T790M mutation,which is statistically significant(P=0.008).in conclusionFor patients with lung adenocarcinoma with EGFR mutations,univariate analysis showed that lymph node metastasis,first-line Icotinib treatment,and ECOG score were associated with T790M mutation.Multivariate analysis only had lymph node metastasis,and first-line Icotinib treatment was associated with T790M mutation,suggesting lymph nodes.Patients with metastases and first-line Icotinib therapy are more likely to develop T790M mutations.The longer the PFS1 in patients with lung adenocarcinoma,the greater the possibility of T790M mutation.