Relationship Between Gene Mutations Of Epidermal Growth Factor Receptor And Clinicopathologic Features Of Non-small Cell Lung Cancer

Background: Lung cancer is currently the highest incidence and mortality ofcancer. lung cancer can be divided into small cell lung cancer (SCLC,about20%) andnon-small cell lung cancer (NSCLC,about80%) by the histological types. Epidermalgrowth factor receptor-tyrosine kinases inhibitors (EGFR-TKIs) molecular targetedtherapy in the treatment of advanced non-small cell lung cancers (NSCLC) withsensitive mutations obtains a breakthrough.The large clinical studies ofIPASS,OPTIMAL,EURTAC have shown the efficiency of EGFR-TKIs could reach58%-83%in NSCLC of the epidermal growth factor receptor (EGFR) mutation,median overall survival time could increase18months to30months.Although thepatients had sensitive EGFR mutations, there is a big difference on the efficacy ofEGFR-TKIs therapy, and eventually there will be drug resistance. The studies of therecent years suggest that, these phenomena may be related to the inhomogeneity ofEGFR mutations.Professor Yilong Wu and Qing Zhou have proposed the concept ofabundance of EGFR mutations on the JCO reveals the heterogeneity of EGFRmutations in NSCLC.We use real-time fluorescence quantitative polymerase chainreaction (Real-time PCR) technology to detect the status of EGFR mutations andabundance of EGFR mutations from the paraffin-embedded tissues of342cases ofNSCLC.To investigate the relationship between the abundance of EGFR mutationand the clinicopathological features.Objective: To explore the relationship between the mutations of EGFR gene andclinicopathological characteristics in patients with NSCLC. So we can better guideclinical individualized targeted therapy and to provide reference for prognostic evaluation.Methods: To collecte342cases of NSCLC from October2012to July2013atthe Cancer Hospital of Zhengzhou University, all patients have been pathologicallydiagnosed NSCLC with paraffin-embedded tumor specimens. We use real-timefluorescence quantitative polymerase chain reaction (Real-time PCR) technology todetect the status of EGFR mutations and abundance of EGFR mutations, toinvestigate the relationship between the abundance of EGFR mutation and theclinicopathological features.Results: Somatic mutations of the EGFR gene were identified in168cases with342cases of NSCLC tumor tissue(49.1%).Among patients with EGFR mutations，42.3%(n=71) had exon19,51.2%(n=86) had exon21.Woman，non-smoker andadenocarcinoma show a higher percentage of EGFR mutation (66.0%，62.1%，52.7%， respectively). ctively)． However， there was no association amongage(P=0.101)and TNM stages(Z=-0.992， P=0.321). Somatic higher abundancemutations of the EGFR gene were identified in116cases with the EGFR mutations of166adenocarcinomas (69.9%)，somatic lower abundance mutations of the EGFRgene were identified in50cases(30.1%). There was no association amongsex(P=0.215)，age(P=0.466)，smoker (P=0.201) and TNM stages（Z=-0.578，P=0.563）with the abundance of EGFR mutations.Conclusion: Woman non-smoker and lung adenocarcinoma includingBronchioloalveolar carcinoma show a higher percentage of EGFR mutation inpatients with NSCLC.There was no association among sex，age，smoker and TNM stages theabundance of EGFR mutations.Real-time PCR is a sensitive and accurate method to detect the abundance ofEGFR mutations and can therefore provide useful information for clinical treatm...