The Expression And Significance Of EGFR In Primary Tumor And Lymph Node Metastasis Of Lung Adenocarcinoma

Objective: To investigate the expression and significance of epidermal growth factor receptor(EGFR)in primary tumor and lymph node metastasis of lung adenocarcinoma.Method:1 This study included 46 patients,all from Department of Thoracic surgery,Hebei General Hospital,with the diagnosis of lung cancer who received lobectomy surgery and lymph node sweeping during January 2010 to December 2012.The patients were 37-75 years old with a median age of 60 years old.All the patients were confirmed lung adenocarcinoma pathologically by two junior pathologists,with lymph node metastasis observed.All the participants hadn't accepted any treatment such as chemotherapy and radiotherapy before the surgery,and they had accepted 4 couses of DC chemotherapy.2 Symptoms and pathological results of lung adenocarcinoma patients were recorded.3 The expression of EGFR in primary tumor and lymph node metastasis of lung adenocarcinoma patients in different groups were detected by immunohistochemistry,grouping on clinical and pathological characteristics.4 Using SPSS 13.0 software for Statistical analysis.Results:1 The expression of EGFR in primary tumors and lymph node metastases of lung adenocarcinoma patients: The positive expression rate of EGFR in primary tumor and lymph node metastasis of lung adenocarcinoma patients were 47.8% and 52.2% respectively,The difference of EGFR expression between two groups had statistical significance(P<0.05).According to gender: The expression of EGFR in primary tumors had no statistical difference between male group and female group(?2=2.333,P>0.05);The expression of EGFR in lymph node metastases had no statistical difference between male group and female group(?2=2.102,P>0.05).According to age: The expression of EGFR in primary tumors had no statistical difference between patients less than 60 years old and patients over 60(?2=0.809,P>0.05);The expression of EGFR in lymph node metastases had no statistical difference between patients less than 60 years old and patients over 60(?2=0.080,P>0.05).According to the location of lesion: The expression of EGFR in primary tumors had no statistical difference between left lung lesion group and right lung lesion group(?2=0.809,P>0.05);The expression of EGFR in lymph node metastases had no statistical difference between left lung lesion group and right lung lesion group(?2=0.080,P>0.05).According to the degree of differentiation: The expression of EGFR in primary tumors had no statistical difference between high degree of differentiation group and middle-low degree of differentiation group(?2=0.038,P > 0.05);The expression of EGFR in lymph node metastases had no statistical difference between high degree of differentiation group and middle-low degree of differentiation group(?2=0.199,P>0.05).According to smoking history: The expression of EGFR in primary tumors had no statistical difference between patients with or without smoking history(?2=0.947,P > 0.05);The expression of EGFR in lymph node metastases had no statistical difference between patients with or without smoking history(?2=0.708,P>0.05).According to TNM staging: The expression of EGFR in primary tumors had no statistical difference between different TNM staging groups(?2=0.382,P > 0.05);The expression of EGFR in lymph node metastases had no statistical difference between different TNM staging groups(?2=1.344,P>0.05).According to the tumor size: The expression of EGFR in primary tumors had no statistical difference between different tumor size groups(?2=0.001,P>0.05);The expression of EGFR in lymph node metastases had no statistical difference between different tumor size groups(?2=0.382,P>0.05).2 The consistency of EGFR in primary tumors and lymph node metastases of lung adenocarcinoma patients: Of all the 46 patients,there were 33 patients who expressed EGFR consistently in primary tumors and lymph node metastases.The expression of EGFR in primary tumors and lymph node metastases had consistency through Kappa consistency check,and the intensity of consistency was medium-grade(K=0.563,P<0.05).According to gender: The expression of EGFR in primary tumors and lymph node metastases had consistency in male group,and the intensity of consistency was high-grade(K=0.821,P<0.05);The expression of EGFR in primary tumors and lymph node metastases had consistency in female group(K=0.327,P<0.05).According to age: The expression of EGFR in primary tumors and lymph node metastases had consistency in patients less than 60 years old(K=0.567,P<0.05);The expression of EGFR in primary tumors and lymph node metastases had consistency in patients over 60(K=0.556,P<0.05).According to the location of lesion: The expression of EGFR in primary tumors and lymph node metastases had consistency in left lung lesion group(K=0.626,P<0.05);The expression of EGFR in primary tumors and lymph node metastases had consistency in right lung lesion group(K=0.514,P<0.05).According to the degree of differentiation: The expression of EGFR in primary tumors and lymph node metastases had consistency in high degree of differentiation group(K=0.533,P<0.05);The expression of EGFR in primary tumors and lymph node metastases had consistency in middle-low degree of differentiation group(K=0.614,P<0.05).According to smoking history: The expression of EGFR in primary tumors and lymph node metastases had consistency in patients with smoking history,and the intensity of consistency was high-grade(K=0.814,P<0.05);The expression of EGFR in primary tumors and lymph node metastases had consistency in patients without smoking history(K=0.368,P<0.05).According to TNM staging: The expression of EGFR in primary tumors and lymph node metastases had consistency in ?stage group(K=0.508,P<0.05);The expression of EGFR in primary tumors and lymph node metastases had consistency in stage group(? K=0.646,P<0.05).According to the tumor size: The expression of EGFR in primary tumors and lymph node metastases had consistency in patients whose tumor's diameter<4cm(K=0.710,P<0.05);The expression of EGFR in primary tumors and lymph node metastases had consistency in patients whose tumor's diameter?4cm(K=0.438,P<0.05).3 Relationship between the expression of EGFR in primary tumors and lymph node metastases and time-to-live of lung adenocarcinoma patients: Of all the 46 patients,3-year survival rate of patients with EGFR expressed positively in primary tumors was 27.3%,significantly lower than that of patients with EGFR expressed negatively in primary tumors 33.3%(P<0.05).3-year survival rate of patients with EGFR expressed positively in lymph node metastases was 12.5%,significantly lower than that of patients with EGFR expressed negatively in lymph node metastases 86.4%(P<0.05).Conclusion:1 EGFR was expressed positively in primary tumors and lymph node metastases of lung adenocarcinoma patients.2 The expression of EGFR in primary tumors was consistent with that in lymph node metastases of lung adenocarcinoma patients,suggesting that EGFR expressed stably during metastasis of lung adenocarcinoma.3 The 3-year survival rate of patients with EGFR expressed positively in either primary tumors or lymph node metastases was significantly lower,suggesting the expression of EGFR was correlated with time-to-live of lung adenocarcinoma patients.