Comparison Of NGS Gene Mutation Status And Influencing Factors In The Blood And Tissue Of Patients With Stage Ⅳ Non-small Cell Lung Cancer

Background and objective:Next-generation sequencing(NGS)is important in the diagnosis and treatment of lung cancer.In recent years,liquid biopsy has been widely used and is considered to be an important supplement to the detection of NGS in tumor tissues.There were few previous reports on the factors affecting the accuracy of liquid biopsy in patients.The purpose of this study was to investigate the coincidence and factors of NGS detection between tumor tissue and blood in patients with untreated IV stage non-squamous non-small cell lung cancer.Methods: The patients with NSCLC diagnosed by pathology in the Oncology Department of the second affiliated hospital of Nanchang University from March 2019 to November 2021 were retrospectively analyzed.The NGS technique was used to analyze level 1 mutations in tumor tissue and blood,and the consistency of the Kappa coefficient was evaluated.χ2 and multivariate logistic regression analysis were used to analyze the factors.Results: A total of 156 patients were included.In female patients,42.9%(67/156),non-smokers 73.7%(115/156),and 64.1%(100/156)had level 1 mutations in tumor tissue or blood,with an overall coincidence rate of 85.90%(Kappa = 0.714,sensitivity82.11%,specificity 91.80%,positive predictive value 93.98%,negative predictive value 76.71%).In the multivariate logistic regression analysis of patients with concordant(n = 78)and discordant(n = 22)mutations,regional lymph node metastasis,bone metastasis,and lesion diameter were independent factors affecting the coincidence of level 1 mutations(OR = 7.632,95%CI 1.556–37.433,P = 0.012;OR =8.752,95%CI 1.749–43.801,P = 0.008;OR = 4.349,95%CI 1.058–17.885,P = 0.042).Conclusion: The liquid biopsy of cell-free/circulating tumor DNA(cf/ct DNA)based on NGS has good consistency with tumor tissue biopsy.Liquid biopsy is preferred to determine the mutation type of IV stage non-squamous non-small cell lung cancer with lesion diameter ≥ 3 cm,lymph node metastasis ≥ N2 and bone metastasis.