Predictive Value Of PIK3CA And PTEN In Advanced Non-small Cell Lung Cancer Treated With EGFR-TKIs

Objectives To evaluate the predictive value of PIK3 CA and PTEN in advanced non-small cell lung cancer patients treated with EGFR-TKIs.Methods Patients who visited the department of respiratory and critical care medicine in the first affiliated hospital of Bengbu medical college from September 2015 to December 2017 were collected.These patients obtained pathological tissues through fiberoptic bronchoscopy or B-ultrasound-guided percutaneous lung puncture or CT-guided percutaneous lung puncture,and were diagnosed as NSCLC by the department of pathology of our hospital.Patients with EGFR mutation and agreed to receive first-line EGFR-TKIs therapy were included in this study.According to the inclusion criteria and exclusion criteria,35 cases were finally enrolled.IHC method is used to detect PIK3 CA and PTEN expression in advanced NSCLC with EGFR mutation,the curative effect of EGFR-TKIs follow-up of patients,disease progression-free time namely appear resistant time,overall survival.The expression of PIK3 CA and PTEN in advanced NSCLC with EGFR mutant was analyzed.To analyze the correlation between PIK3 CA and PTEN expression in advanced NSCLC with EGFR mutation,the correlation between PIK3 CA with PTEN expression in advanced NSCLC with EGFR mutation,and the correlation between PIK3 CA wuth PTEN expression in advanced NSCLC with EGFR mutation.To evaluate the drug resistance time and total survival of PIK3 CA and PTEN in advanced non-small cell lung cancer patients treated with EGFR-TKIs.Results(1)In advanced NSCLC with EGFR mutation,the expression of PIK3 CA and PTEN were mainly located in the cytoplasm or nucleus,the positive expression rate of PIK3 CA was 48.57%,the positive expression rate of PTEN was 31.43%(2)The expression of PIK3 CA and PTEN had no correlation with gender,age,TNM stage,smoking,brain metastasis,lymph node metastasis,pathological type and EGFR mutation site of patients(P > 0.05).(3)There was a negative correlation between PIK3 CA with PTEN expression in NSCLC with EGFR mutation,with statistical difference(r=-0.412,P<0.05).(4)In the NSCLC patients treated with EGFR-TKIs,the drug resistance rate of EGFR-TKIs with positive PIK3 CA expression was significantlyhigher than that of patients with negative PIK3 CA expression,the PFS was shortened,and the overall survival period was significantly shortened.There was significant difference in survival curve between the two groups(P<0.05).Compared with patients with negative PTEN expression,patients with positive PTEN expression showed significantly higher drug resistance rate of EGFR-TKIs,significantly longer PFS,and significantly longer overall survival.There was significant difference in survival curve between the two groups(P<0.05).(5)In the NSCLC patients with EGFR mutant,the drug resistance rate of EGFR-TKIs in PIK3 CA / PTEN-group was significantly higher than that in PIK3CA-/PTEN group,the PFS was significantly shorter and the overall survival time was significantly shorter.There was a significant difference in survival curve between the two groups(P<0.05).Conclusion(1)In NSCLC tumor specimens with EGFR mutant,the positive expression rate of PIK3 CA was 48.57%,the positive expression rate of PTEN was 31.43%.(2)There was a negative correlation between PIK3 CA and PTEN expression in EGFR mutant NSCLC tumor tissues.(3)The expression of PIK3 CA and PTEN was significantly correlated with the drug resistance and overall survival of patients with EGFR mutant NSCLC treated with EGFR-TKIs.The higher the expression of PIK3 CA and the lower the expression of PTEN,the shorter the resistance time of EGFR-TKIs and the shorter the overall survival time.(4)According to the expression of PIK3 CA and PTEN in advanced NSCLC with EGFR mutation,the treatment of NSCLC patients with EGFR-TKIs can be selected to predict the occurrence of drug resistance and the overall survival of patients after the application of EGFR-TKIs.So that early intervention can be conducted to extend the survival of patients.