Mutation Analysis Of ECFR&K-RAS By Realtime Polymerase Chain Reaction Using Scorpion Amplification Refractory Mutation System And Relationship Between EGFR&K-RAS Mutation And Response To Tyrosine Kinase Inhibitor Treatment In Chinese Patients With Non-sma

Objective:To investigate gene mutation information of EGFR and K-ras in Chinese patients with NSCLC, and to analyze the relationship between gene mutation and the clinicopathological feature&EGFR-TKI efficiency.Method:Detecting EGFR mutation of120patients and K-ras mutation of104patients with NSCLC in PUMCH from March2009to December2010, and analyzing the relationship between gene mutation information and the clinicopathological&EGFR-TKI efficiency.Result:44patients (mutation rate:36.7%) are detected EGFR mutation in120patients with NSCLC. In these44patients, three kinds of EGFR gene mutations are dectected:EGFR exon19deletion mutation;EGFR exon21L858R (2573T>G)mutation;EGFR Exon21L861Q (2582T>A)mutation. There are29patients detected EGFR exon19deletion mutation(mutation rate:24.2%),14patients detected EGFR exon21L858R mutation(mutation rate:11.7%), and1patient detected EGFR exon21L861Q mutation(mutation rate:0.8%) among all EGFR detected patients. All the mutations are single point mutations, and no multiple points mutations are detected. EGFR mutation rate of bronchioloalveolar carcinoma and adenocarcinoma are higher than that of non-adenocarcinoma (P=0.009). EGFR mutation rate is higher in female patients or patients without smoking history than male patients or patients with smoking history (P=0.014, P=0.001, respective) in NSCLC patients. EGFR mutation rate is higher in patients without smoking history and patients with well-differentiated carcinoma than patients with smoking history and patients with moderately and poorly differentiated carcinoma(P=0.008, P=0.018, respective). There isn’t any differentce in prognosis and EGFR-TKI treatment response rate between EGFR mutation patients and EGFR wild-type patients.9patients(mutation rate:8.7%) are detected K-ras mutation in104NSCLC patients. There are four kinds of K-ras gene mutations are dectected: K-ras Gly12Ala(GGT>GCT), K-ras Gly12Arg(GGT>CGT), K-ras G1y12Val(GGT>GTT), K-ras Gly12Cys(GGT>TGT).There are4patients detected12exon Cys mutation,2patients detected12exon Arg mutation,2patients detected12exon Val mutation, and1patient detected mutiple points mutation of both12exon Cys mutation and12exon Ala mutation. No relationship is found between K-ras mutation and clinicopathological feature either in NSCLC or in adenocarcinoma. Prognosis is worse in patients detected K-ras mutation than in wild-type patients(P=0.008).No patient was detected both EGFR and K-ras mutation.Conclusion:EGFR mutation rate is higher in Chinese patients with NSCLC than that of Western countries, but is similar with Japan. EGFR mutation rate is related with gender, smoking history and Pathology type in NSCLC patients, and is related with differentiation and smoking history in adenocarcinoma patients. K-ras mutation rate is lower in Chinese patients with NSCLC than that of Western countries, but is similar with Japan. And prognosis is worse in K-ras mutation patients than wild type patients.