The Correlation Study Of EGFR Mutation With Expression Of EGFR,TTF-1 And Serum CEA Level In Lung Adenocarcinoma

Background and objective: Lung cancer is a major public health problem that has been plaguing the world all the time.The number of deaths caused by lung cancer has leapt to the top of malignant tumors,which is a serious threat to human health.In recent twenty years,the proportion of adenocarcinoma in lung cancer has been increasing.Some studies have pointed out that the incidence of adenocarcinoma has been more than the other types of lung cancer,proved to be the main pathological type of lung cancer.With the continuous improvement of treatment in recent years,In recent years,molecular targeted drug development is most rapid,one of the most typical and successful is the EGFR tyrosine kinase inhibitor(TKI)in the treatment of advanced non small cell in patients with EGFR-TKI,especially in non small cell lung cancer shows its great potential with the EGFR mutation.And the mutation of EGFR gene in lung adenocarcinoma was significantly higher than that of other pathological types in lung cancer,so the molecular targeting EGFR signaling pathway has become an important means for treatment of patients with advanced lung adenocarcinoma.However,the detection of EGFR gene mutations is critical for the acquisition and detection of tumor tissue.In China,the detection of gene mutation is limited,and the cost of detection is high.It is difficult to improve the clinical application of the basic level hospitals in most underdeveloped areas or developed regions.The purpose of this study was to investigate the relationship between EGFR gene mutation and the expression levels of EGFR,-1(transcription),TTF-1(thyroid)and CEA in patients with lung adenocarcinoma.In order to predict the mutation of EGFR gene in patients with adenocarcinoma,and to guide the individualized application of targeted drugs.Methods: Collect fresh pathological tissues in 50 cases of lung cancer patients,EGFR gene mutation detection by ARMS method,the expression level and immunohistochemistry method was used to detect EGFR and TTF-1 in pathological tissue,and collected serum CEA level before treatment.The data were processed by chi square test,single factor and multi factor logistics regression.Results: Among all 50 samples,EGFR gene mutation rate was 58%,the positive rate of EGFR was 66%,the positive rate of TTF-1 was 84%,the serum CEA abnormality rate was 40%.There were 24 cases of EGFR gene mutation in EGFR positive group(73%).There were 26 cases of EGFR gene mutation in TTF-1 positive group(62%).There were 15 cases of EGFR gene mutation in patients with elevated serum CEA before treatment(75%).There was no correlation between EGFR gene mutation and gender,age,smoking and tumor stage(P > 0.05).After a Multi-logistic Regression Analysis,the high expression of EGFR and the increase of serum CEA were independent predictive factors of EGFR gene mutation,and the difference was statistically significant(OR=5.754,P=0.039;OR=5.344,P=0.040).The positive expression of TTF-1 in lung adenocarcinoma is not an independent risk factor for EGFR gene mutation(OR=4.838,P=0.179).Conclusion: The expression of TTF-1 and EGFR mutation showed no obvious correlation,the expression of EGFR protein and EGFR gene mutation is closely related,the high value of CEA gene EGFR mutation group and the close relationship between the expression of EGFR protein and serum CEA level before treatment in a certain extent can be used to predict the probability of patients with mutations in the EGFR gene,can be used as objective EGFR-TKI indicators to guide the treatment of lung adenocarcinoma patients.