To Investigate The Clinical Significance Of Epidermal Growth Facter Gege Mutation In Non-Cell Lung Cancer

Objective:To investigate the associations between the mutations of exons 19 and 21 of epidermal growth factor receptor (EGFR) genes and clinicopathological characteristics, and family history in non-small cell lung cancer (NSCLC) and further explore the curative effect of targeted therapy in patients with positive mutations by used epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs).Methods:Pathologically comfirmed non-small cell lung cancer or lung cancer lymph node metastasis specimens of a total 162 cases was collected. specimens were fixed in 10% formalin,embeded in paraffin,sliced,and then extracted the tumor tissue dewaxing,and finally DNA was extracted.Amplification refractory mutation system-Polymerase Chain Reaction(ARMS-PCR) was applied to detect the mutations of exons 19 andResults:1.Our results showed that 63 patients were with positive EGFR mutations in 162 NSCLC patients. The total mutation rate of EGFR gene was 38.89%. The mutation rate of adenocarcinoma was 44.44% and the mutation rate of squamous cell carcinoma was 11.11%.2.Mutation rate was higher in the patients who were with some characteristic such as adenocarcinoma, woman, non-smoking, and family history with malignancy (p<0.05). However, the mutation rate has no significant correlation with patient age, tumor grade, stage, size, metastasis or not(p>0.05).3.EGFR screening is necessary to the sqamous cell lung cancer patients with a family history of lung cancer,gastrointestinal metastases or non smoking history.4.Have a first degree family history of lung cancer and other malignant tumor patients were more likely to detected EGFR mutation, and also in exon 19 and exon 21 mutation rate (P<0.05). The mutation rates of these two sites were more than 50%.5. The median surval time of NSCLC patients who were treated by epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) showed a longer median survival time (p<0.05) in patients with positive mutation.Conclusion:EGFR mutations were common in adenocarcinoma, female, non-small-cell lung cancer patients, and squamous of cell carcinoma in some characteristics could also be found. The EGFR mutation rate of the non small cell lung cancer patients with the first degree family history of malignancy was more than 50%, so the first degree family history of malignant tumor could be as the independent risk factor for the occurrence of mutation. Therefor, the screening of EGFR mutations should be used as a routine examination in the patients who suffered NSCLC.Especially, it has more clinical significance in patients with first degree family history of malignant tumor. The median survival time after the targeted therapy was significantly prolonged for patients with mutation, so it was necessary to use targeted therapy for this part of the patients.