Abstract
BackgroundIn the Xuanwei region of China, lung cancer incidence and mortality are among the highest in China, attributed to severe air pollution generated by combustion of smoky coal. No study has yet comprehensively evaluated the prevalence of epidermal growth factor receptor (EGFR) mutation characteristics in patients with non-small cell lung cancer (NSCLC) in Xuanwei. This meta-analysis was designed to analyze the EGFR mutation pattern in NSCLC patients in Xuanwei region of Yunnan Province in China.MethodsElectronic databases were comprehensively searched and relevant literatures were retrieved. The odds ratio (OR) for EGFR mutations between Xuanwei region and non-Xuanwei region was calculated, and the absolute incidence of EGFR mutations in Xuanwei was pooled by mutation subtype.ResultsSeven studies involving 1,355 patients with NSCLC from Yunnan Province (442 in Xuanwei and 913 in other regions) were included. The EGFR mutation rate ranged between 30.19% and 55.56%. Higher uncommon EGFR mutations (OR: 5.69, 95%CI: 2.23–14.49, P<0.001) and lower common EGFR mutations (OR: 0.18, 95%CI: 0.07–0.45, P<0.001) were found in Xuanwei region, compared with non-Xuanwei region. Specifically, the uncommon EGFR mutation rate was 59.50% and common EGFR mutation rate was 40.50% in Xuanwei. The mutation incidence of exon 18 G719X (OR: 3.21, 95%CI: 1.48–6.97, P=0.003), exon 20 S768I (OR: 6.44; 95%CI: 2.66–15.60; P<0.001), and exon 18 G719X + 20 S768I (OR: 6.55; 95%CI: 1.92–22.33; P=0.003) in Xuanwei were significantly higher, while the frequency of 19 deletion (OR: 0.28, 95%CI: 0.11–0.77, P<0.001) and 21 L858R mutation (OR: 0.51, 95%CI: 0.31–0.84, P=0.007) were lower.ConclusionsThe results highlight the distinct EGFR mutation spectrum of NSCLC patients in Xuanwei region compared with other regions, with higher uncommon mutations but lower common mutations. The distinct Xuanwei featured genetic variations provide a unique model to further study carcinogenesis of lung cancer.
Highlights
Lung cancer has the highest morbidity and is the leading cause of cancer-related death worldwide, with 85% of patients having nonsmall-cell lung cancer (NSCLC) [1, 2]
Higher uncommon Epidermal growth factor receptor (EGFR) mutations (OR: 5.69, 95%CI: 2.23–14.49, P
The results highlight the distinct EGFR mutation spectrum of NSCLC patients in Xuanwei region compared with other regions, with higher uncommon
Summary
Lung cancer has the highest morbidity and is the leading cause of cancer-related death worldwide, with 85% of patients having nonsmall-cell lung cancer (NSCLC) [1, 2]. Epidermal growth factor receptor (EGFR) is a well-accepted carcinogenic variant and driver gene in lung cancer. NSCLC patients with activating EGFR mutations are identified in about 40~60% of Asian and 10% of Western populations [3]. A genetic divergence of EGFR mutation rates was demonstrated according to ethnicity in previous research [6, 7], and the frequency of EGFR was highest among Asians (47%) and lowest among Oceanians (12%) [8]. No study has yet comprehensively evaluated the prevalence of epidermal growth factor receptor (EGFR) mutation characteristics in patients with non-small cell lung cancer (NSCLC) in Xuanwei.
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