Relationship Of Clinicopathological Characteristics,EGFR Genotyping And Prognosis In Non-small Cell Lung Cancer Patients With Malignant Pleural Effusion

Objective: To investigate the relationship of the clinical characteristics,EGFR genotyping and prognostic factors of malignant pleural effusion(MPE)associated with non-small cell lung cancer(NSCLC).Materials and Methods: A total of 321 patients hospitalized in Guangxi Medical University Affiliated Tumor Hospital from November 2013 to December 2017 who were pathologically or cytologically confirmed NSCLC with malignant pleural effusion(MPE)at initial diagnosis or developed MPE following disease progression were enrolled in the study,all patients are in stage IV.The information including gender,age,smoking status,ECOG score,type of biopsy specimen,the degree of differentiation,pathological type,primary site and anatomical classification of the lesion,pleural effusion status,metastasis of lesions,EGFR mutation status,therapeutic method and prognosis for patients above were retrospectively extracted and analyzed.The data were analyzed by SPSS 21.0 software.Chi-square test was used for comparison between groups,and Fisher's exact probability method was used for correction.Survival curves were drawn by Kaplan-Meier method,and the differences between groups were compared by log-rank test.All P values were two sided and consideredsignificant if less than 0.05.Results:1.Patients with MPE at initial diagnosis had later tumor staging(p=0.003)and higher incidence of bone metastasis(p=0.003)than those with MPE at diseases progression,the difference was statistically significant.However,the pathological type,the degree of differentiation,smoking status,gender,EGFR mutation status in the above patients were no significant difference(P>0.05).2.Of 321 patients with MPE,252 patients had ECOG score of 0-1,69 of them had more than 2 score,the mOS of them were 15.4 months and 7.4 months,respectively,the difference was statistically significant(P=0.000).3.Of the 321 patients included in this study,167 patients received thoracic perfusion therapy,154 did not receive thoracic perfusion therapy,the mOS of them were 13.6 months and 13.4 months,respectively.There was no significant difference in the prognosis(P=0.929).4.A total of 129 patients were conducted EGFR testing and treated with Systemic therapy.Among patients with EGFR mutation,56 patients were treated with TKI,and 15 patients were treated with chemotherapy,the mOS of them were 21.9 months and 13.4 months,respectively;among EGFR wild-type patients,24 patients were treated with TKI,and 34 patients were treated with chemotherapy,the mOS of them were 17.1 months and 12.2 months,respectively,the difference was statistically significant(p=0.008).Conclusion: 1.Through comparing clinicopathological characteristics,EGFR genotyping and prognosis in MPE patients,those whose MPE were identified at the time of diagnosis are more frequently a higher incidence bone metastasis and had later tumor staging.2.ECOG score ?2 was significantly correlated with the decline of survivalin patients with MPE.3.There was no significant difference in OS between patients with and without thoracic perfusion therapy.4.Patients with EGFR mutation and treated with EGFR-TKI had longer OS.