The Related Research Of Primary Lung Cancer With Mediastinal Etastasis Lymph Node Difference Of EGFR Mutation

Objective:Lung cancer is the most common cancer worldwide,an estimated 160 new patients each year,accounting for 12.7% cases of malignant tumor,accounting for 26.8% of cancer deaths.Non small cell lung cancer(non-small cell lung cancer,NSCLC,NSCLC)is the main type of lung cancer,accounting for 80%~85% of the total number of lung cancer.However,the vast majority of lung cancer patients at the time of diagnosis is III~IV,lobectomy plus mediastinal lymph node dissection has not completely cure the tumor;platinum based chemotherapy efficacy of traditional Co,the mutation of oncogene encoding drive signal molecules in tumor cell proliferation and growth of the discovery,to promote a more effective and less toxic therapy targeting rapid in particular,epidermal growth factor receptor tyrosine kinase inhibitors(epithelial growth factor receptor tyrosine kinase inhibitor,EGFR-TKI)of EGFR gene mutation in non-small cell lung cancer patients with significant effect.Clinical use of tissue samples in the process of surgery is generally used for gene detection,but patients with advanced lung cancer often do not get tumor gross specimens.This project is through the detection of primary lung cancer and mediastinal lymph node metastasis EGFR mutation,understanding of primary lung cancer and metastasis of mediastinal lymph node EGFR mutation rate has no difference,whether there is heterogeneity between two or more easy to get to,through the detection of the mediastinal lymph node and even surface transfer will be able to know the tumor the EGFR mutation data,to guide targeted therapy of lung cancer.Methods:From January 2015 to December 2015,100 cases of mediastinal metastatic lymph nodes were collected in our hospital for surgical resection of non small cell lung cancer and over the same period.Each of the 1 primary lung cancer specimens and 1 mediastinal metastatic lymph nodes were taken from each patient.Polymerase chain reaction(PCR)arms of NSCLC primary EGFR gene in the tumor tissue of mutation and mediastinal metastatic lymph nodes in the EGFR gene mutation: firstly,genomic DNA was extracted,and then to extract the genomic DNA using arms was amplified,were amplified EGFR the 21 exons,than both mutation rate.SPSS17.0 software was used to analyze.Enumeration data was tested by chi-square test,and measurement data was tested by t test.P > 0.05 indicated that there was no difference in EGFR mutation rate between primary tumor and mediastinal metastatic lymph nodes.Results:1.In 100 patients with non-small cell lung cancer,aged 42 years old ~75 years old,the median age was 61 years old,among them 60 years old patients were 57 cases,accounting for 57%.A total of 100 cases of primary tumor of lung cancer and mediastinal metastatic lymph nodes were detected.2.In this experiment,the total of 100 patients with NSCLC patients with primary tumor and mediastinal metastatic lymph nodes of the detection of EGFR gene,of which a total of 37 cases of non small cell lung cancer patients with primary foci detected EGFR gene region mutation,mutation rate was 37%,A total of 34 cases of non small cell lung cancer with EGFR gene mutation in the primary lesions were detected in 37 cases with EGFR gene mutation,the mutation rate was 34%.Among the 100 patients with EGFR mutation,there were 34 cases of central plain and mediastinal metastatic lymph nodes,including 21 exon mutations in 31 cases,19 exon mutations in 36 cases,18 exon 2 mutations and 20 exon mutations in 2 cases.In one case,EGFR gene mutations were detected before chemotherapy,and no mutations were detected after chemotherapy.The mutation of EGFR gene was mainly concentrated in exon 18,19,20,21.The 19 and 21 exon mutation rate was significantly higher.3.The vast most NSCLC patients primary tumor and mediastinal metastatic lymph nodes of EGFR have mutations: 91.89%(34/37)or both no mutations: 95.45%(63/66);3 cases of patients with lung cancer primary tumor mutations,but mediastinal metastatic lymph nodes without the mutation and lung cancer primary lesions and mediastinal metastatic lymph nodes of EGFR mutation consistent rate reached: 91.89%(34/37)?4.Through statistical analysis,there was no difference in EGFR mutation rate between primary tumor and mediastinal metastatic lymph nodes in lung cancer: P > 0.05.Conclusion:1.Analysis of EGFR gene mutation in NSCLC tissue and mediastinal metastatic lymph nodes by PCR amplified ARMS method is simple and feasible.2.Through the research,we found that lung cancer primary tumor and mediastinal metastatic lymph nodes of EGFR mutation rate difference,P > 0.05,primary lung lesion and mediastinal metastatic lymph nodes EGFR mutation rates were not significantly different between the groups,the vast majority of patients with NSCLC primary tumor and mediastinal metastatic lymph nodes have mutations are also: 91.89%(34/37),and primary lung cancer lesions and mediastinal metastatic lymph nodes of EGFR mutation rate is consistent.3.EGFR mutation rate of primary tumor and mediastinal metastatic lymph nodes of NSCLC lung cancer was no difference,and the EGFR gene mutation data of mediastinal metastatic lymph nodes could represent the EGFR gene mutation data of primary lung cancer.Many cases of advanced lung cancer although not cut in primary foci of tumor EGFR gene detection,but can take to mediastinal metastatic lymph nodes,expression of EGFR gene transfer to replace the lung cancer primary foci of EGFR gene detection and guiding lung target to treatment.