Analysis of gene mutation status and prognosis in lung cancer patients younger than 35 years old: a retrospective study

Abstract

Objective To analyze the correlation between gene mutation status and prognosis in lung cancer patients younger than 35 years old. Methods Totally 52 cases of lung cancer were enrolled.The clinical feathers (including age, gender, smoking, initial manifestation, radiologic characteristics, disease stages, treatment modalities), epidermal growth factor receptor (EGFR) and EML4-ALK mutation status as well as the prognosis were retrospectively evaluated. Results In the 52 lung cancer patients, female patients took a higher proportion (59.6%). Most of the cases were pathologically diagnosed as adenocarcinoma (78.8%). Of the 47 non-small cell lung cancer patients, 17 cases were stage 0-ⅢA while other 30 cases in stage ⅢB-Ⅳ, including 27 cases in stage Ⅳ.EGFR mutation and EML4-ALK fusion gene were detected in 22 patients with non-small cell lung cancer, in which seven cases (31.8%) harboring EGFR mutation, and six cases (27.3%) were EML4-ALK positive.83.3% of EML4-ALK positive patients had single substantial masses or nodules according to chest CT scans.71.4% EGFR mutated patients were diagnosed at stage Ⅳ.The median survival was 24.6 months in a cohort of 50 patients receiving regular follow-up.Different stages, surgical operation and gene mutation status were the key factors affecting the survival. Conclusions Lung cancer patients younger than 35 years old have several unique characteristics: more female patients, more adenocarcinoma, and more advanced stage cases.EGFR and EML4-ALK mutation are frequent in this group of patients compared to general lung cancer patients.EML4-ALK positive patients mostly have single substantial masses or modules according to chest CT scans.EGFR mutated patients are usually diagnosed at stage Ⅳ.The early stage, treatment of surgical operation and mutated gene are related to favorable outcome. Key words: Lung cancer; Young patient; Epidermal growth factor receptor; Anaplastic lymphoma kinase; Prognosis