非小细胞肺癌E19-Del、L858R突变临床特征分析

Clinical features of E19-Del and L858R gene mutations in patients with non-small cell lung cancer

目的探讨非小细胞肺癌E19-Del、L858R突变临床特征。方法纳入2012年7月至2018年7月在空军军医大学第二附属医院呼吸与危重症医学科基因检测中心行EGFR基因检测的498例非小细胞肺癌肺癌患者,回顾性分析其E19-Del、L858R突变临床特征及相互间突变的差异。结果E19-Del在小于50岁、大于等于70岁、大于等于50岁而小于70岁时突变率逐渐降低(χ^2=5.984,P=0.050),不吸烟组E19-Del突变率高于吸烟每天大于20支组(χ^2=4.328,P=0.037),E19-Del在腺癌组、鳞癌组、其他类型非小细胞肺癌组突变率逐渐降低(χ^2=12.197,P=0.000),E19-Del在Ⅳ期、Ⅲ期、Ⅰ+Ⅱ期突变率逐渐降低(χ^2=6.625,P=0.036),以上均有统计学差异;L858R女性突变率高于男性(χ^2=13.755,P=0.000),L858R在不吸烟组、吸烟每天小于或等于20支组、吸烟每天大于20支组突变率逐渐降低(χ^2=7.234,P=0.027),L858R在腺癌组、其他类型非小细胞肺癌组突变率逐渐降低(χ^2=5.538,P=0.021),胸膜转移组L858R突变率高于未发生胸膜转移组(χ^2=4.004,P=0.045),以上均有统计学差异。结论E19-Del在年轻非吸烟Ⅳ腺癌组突变率高;L858R在女性非吸烟腺癌并胸膜转移组突变率高;E19-Del、L858R在肿瘤发生部位,有无并发糖尿病、高血压、其它肿瘤或是否存在骨转移、头颅转移、淋巴结转移时突变率各有差异,但均无统计学差异。

Objective To study the clinical characteristics of patients of non-small cell lung cancer(NSCLC)who had E19-Del and L852R gene mutation.Methods This study summarized total 498 patients of NSCLC who received gene tests in respiratory and critical care medicine department in Tangdu hospital,The Fourth Military Medical University from Jul.2012 to Jul.2018.The correlations between the E19-Del and L852R gene mutation and the clinical characteristics of the patients were retrospective analyzed.Results E19-Del gene mutation rate was declining in the following groups:the age less than 50 years,the age more than 70 years and the age between 50 years and 70 years(χ^2=5.984,P=0.050).Non-smokers had higher E19-Del gene mutation rate than patients who smoke more than 20 cigarettes a day(χ^2=4.328,P=0.037).E19-Del gene mutation rate also declined in the following groups:adenocarcinoma and other types of NSCLC(χ^2=12.197,P=0.000).And E19-Del gene mutation rate was declining as the reducing of pathological stage(χ^2=6.625,P=0.036).L858R gene mutation rate of female was higher than male(χ^2=13.755,P=0.000).As the lessening of patients smoking degree,L858R gene mutation rate was declining(χ^2=7.234,P=0.027).L858R gene mutation rate also declined in the following groups:adenocarcinoma and other types of NSCLC(χ^2=5.538,P=0.021).L858R gene mutation of patients who had pleura metastasis was higher than who did not(χ^2=4.004,P=0.045).Conclusion There is some significant difference of clinical features in E19-Del gene mutation with non-smoking and young people in NSCLC.Then L858R gene mutation rate was high in non-smoking women and patients who had pleura metastasis.Both E19-Del and L858R gene mutation rate had no significant correlations with whether patients had different tumor position,diabetes,high blood pressure,bone metastasis,cranium metastasis and lymphomatous metastasis.