| Objective:Lung cancer has become a major threat to human health factors, Its incidence andmortality ranked first in malignant tumors, in which accounts for the majority of Non-smallcell lung cancer. Because no obvious symptoms of early onset NSCLC, many patientsdiagnosed with cancer has progressed to late. After that some patients abandon treatmentmore than90%will die within a year. Researchers in-depth knowledge of molecularpathology, the medical profession is also widespread concern therapy for epidermal growthfactor receptor-specific targeting, EGFR belongs erB/HER family, Primarily as atransmembrane protein on the cell surface distribution of non-small cell lung cancer targetedtherapy based on blocking the EGFR signaling pathway as a target, at home and abroadpredicted many trials have shown the efficacy of EGFR TKIs elements of the epidermalgrowth factor receptor gene mutations. The test of survival for non-small cell lung cancerenrolled in the epidermal growth factor receptor gene mutations in exons19,21werecompared and analyzed gene mutations in patients with clinical and pathological features ofgefitinib treatment efficacy and patient after treatment to the time. Thus non-small cell lungcancer patients with EGFR gene mutations in exons19,21to provide better targetedindividualized treatment plan and determine prognosis.Methods: The topics treated in our hospital with non-small cell lung cancer patients witha total56cases, the time from June2011to August2012. After histopathology cases werediagnosed as non-small cell lung cancer. Extracted into the group of patients medical recordinformation as required, including sex, age, smoking, histological type, TNM staging,treatment and medication after the application of the efficacy and survival time. Epidermalgrowth factor receptor gene mutation in exon19,21state detection using direct sequencing, simultaneous contrast EGFR gene mutations in exons19,21NSCLC patients with clinicaland pathological features, gefitinib Nigerian relations after treatment efficacy and patientsurvival time after treatment. The resulting test data input SPSS19.0statistical analysissoftware χ2test; using the Kaplan-Meier method between experimental and control groupswere compared survival and the survival function plotted curve, the difference between thegroups application log-rank test, comparing various EGFR19,21exon gene mutationrelationship situation with non-small cell lung cancer survival time. All statistical results ofP<0.05was said that the difference was statistically significant.Results:1. Into the group of patients,26cases of male patients (26/56,46.43%),30cases offemale patients (30/56,53.57%). The age distribution ranges from27to83years old. Themedian age of56.5years. Less than60years old in33cases (33/56，58.93%), over60yearsold in23cases (23/56，41.07%). Adenocarcinoma,41cases (41/56，73.21%),non-adenocarcinoma15cases (15/56,26.79%), smoking24patients (24/56,42.86%),non-smoking32patients (32/56,57.14%), clinical stage Ⅱb19patients (19/56,33.93%), Ⅲ+Ⅳof37patients (37/56,66.07%); specimens source: primary tumors accounted for51.79%(29/56); supraclavicular lymph node metastasis specimens accounted for66.07%(37/56).2. In this study,56patients with NSCLC were enrolled EGFR gene mutations in exons19,21, EGFR gene mutation in exon19of34cases (34/56,60.71%),21exon22cases (22/56,39.29%).3. EGFR gene mutation in exon19,21in patients with adenocarcinoma histological typemutation rate (73.21%) was significantly higher in patients with non-adenocarcinoma(26.79%), the difference between the mutation rate was statistically significant (P <0.01).Mutation rate of male patients (46.43%) lower than the mutation rate of female patients(53.57%), no significant difference between the groups, mutation rate of smokers (42.86%)lower than non-smokers mutation rate (57.14%), there was no statistically significantdifference between groups, while age (less than60years of age in patients with EGFRmutation rate was58.93%, more than60years in patients with EGFR mutation rate of41.07%), clinical stage (Ⅱb mutation rate of33.93%, Ⅲ+ⅳmutation rate of66.07%), primary tumors and metastases (primary tumor mutation rate51.79%, metastases mutationrate66.07%) between the mutation rate was not statistically significant differences.4.56cases of enrolled patients were given at least four cycles of intervention, the testgroup objective response rate was57.14%, disease control rate was85.71%, patients in thecontrol group objective response rat was25.00%, disease control rate was60.71%, betweenthe two groups statistically significant.5. After the test group received gefitinib therapy mPFS to54weeks was significantlyhigher in patients treated with gefitinib did not give (28cases, PFS with a median of30weeks), P=0.001, statistical difference between the two groups significance.6. Accurate survival data in patients with a total of56cases, the test group of28patientsin the control group,28patients in both groups, the median survival time was55weeks (95%CI,40.8weeks-69.2weeks) and35weeks (95%CI,28.9weeks-41.1weeks), p=0.001significant differences between the two groups to survive.Conclusions:1. In this study, completed a total of56cases of genetic testing for mutations in EGFRgene mutation in exon19,21of non-small cell lung cancer patients with mutations in exon19was60.71%, exon21mutation rate was39.29%.2. Patients with adenocarcinoma of the EGFR gene mutation in exon19,21higherincidence, Mutation positive samples drawn from the site of the primary tumor and metastaticlymph node tissue for EGFR gene mutations in exons19,21no significant difference.Different age, clinical stage, ECOG score, tumor site and whether there are lymph nodemetastasis, distant metastasis, surgical resection history and EGFR gene mutations in exons19,21, among the group, the difference was not statistically significant.3. EGFR gene mutations in exons19,21can be used as molecular targeted therapy toassess the effect of the predictor.4. EGFR gene mutations in exons19,21can be used as a predictor of prognosis innon-small cell lung cancer. |
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