肺腺癌患者表皮生长因子受体突变与临床病理特征的相关性

Association between clinicopathological features of lung adenocarcinoma and incidence of EGFR mutation

目的分析肺腺癌患者的表皮生长因子受体(EGFR)突变情况与临床病理特征的相关性,筛选基因筛查优势人群,为EGFR突变筛查及络氨酸激酶抑制剂(TKIs)的临床应用提供理论导向。方法回顾性分析139例行EGFR突变基因筛查的肺腺癌患者相关临床病理参数及EGFR外显子突变情况,应用Pearsonχ2检验进行单因素分析,采用logistic回归模型进行多因素分析,筛选靶向治疗最佳优势人群。结果肺腺癌EGFR突变多见于女性、非大量吸烟、存在肺内转移以及进展期患者。19外显子突变与肺内转移密切相关,21外显子突变与性别、吸烟史及转移器官数量密切相关。女性肺腺癌患者EGFR突变率比男性患者增加3.4倍,发生肺内转移的肺腺癌患者阳性突变率提高3.3倍。女性肺腺癌患者21外显子阳性突变率比男性患者提高7.8倍。结论肺腺癌EGFR突变状态与临床病理特征相关,女性、非大量吸烟、存在肺内转移以及进展期患者阳性突变率高,建议筛查。

Objective To analyze the relationship between clinicopathological features of lung adenocarcinoma and epidermal growth factor receptor(EGFR)mutation status.Methods A total of 139 patients with lung adenocarcinoma who underwent EGFR gene mutation test were selected.Their clinicopathological features and EGFR mutation status were collected retrospectively.Univariate analyses with Pearsonχ2 test and multivariate analyses using logistic regression model were performed to select suitable candidates for targeted therapy.Results Among the patients with lung adenocarcinoma,EGFR mutations were more prevalent in women,non-heavy smokers,patients with intrapulmonary metastasis,and patients in the advanced stages of cancer.Mutation in exon 19 was closely related to intrapulmonary metastasis,while that in exon 21 was closely related to gender,smoking history,and the number of organs with metastases.The EGFR mutation rate in the female patients with lung adenocarcinoma was 3.4 times higher than that in the male patients and mutation rate among patients with intrapulmonary metastasis was 3.3 times higher than those without.For exon 21 mutations,the mutation rate in the female patients was 7.8 times higher than that in the male patients.Conclusion The EGFR mutation in lung adenocarcinoma is associated with clinicopathological features,exhibiting high positive mutation rates in women,non-heavy smokers,patients with intrapulmonary metastasis,and patients in advanced stages of cancer,for whom the screening is recommended.