EGFR Mutations in Surgically Resected Fresh Specimens from 697 Consecutive Chinese Patients with Non-Small Cell Lung Cancer and Their Relationships with Clinical Features

Yuanyang Lai,Yifang Zhu,Lijun Huang,Tao Jiang,Dong Sun,Xiaolong Yan,Yong'An Zhou,Zhipei Zhang,Jianzhong Li,Yong Han,Xiaofei Li

doi:10.3390/ijms141224549

Abstract

We aimed to reveal the true status of epidermal growth factor receptor (EGFR) mutations in Chinese patients with non-small cell lung cancer (NSCLC) after lung resections. EGFR mutations of surgically resected fresh tumor samples from 697 Chinese NSCLC patients were analyzed by Amplification Refractory Mutation System (ARMS). Correlations between EGFR mutation hotspots and clinical features were also explored. Of the 697 NSCLC patients, 235 (33.7%) patients had tyrosine kinase inhibitor (TKIs) sensitive EGFR mutations in 41 (14.5%) of the 282 squamous carcinomas, 155 (52.9%) of the 293 adenocarcinomas, 34 (39.5%) of the 86 adenosquamous carcinomas, one (9.1%) of the 11 large-cell carcinomas, 2 (11.1%) of the 18 sarcomatoid carcinomas, and 2 (28.6%) of the 7 mucoepidermoid carcinomas. TKIs sensitive EGFR mutations were more frequently found in female patients (p < 0.001), non-smokers (p = 0.047) and adenocarcinomas (p < 0.001). The rates of exon 19 deletion mutation (19-del), exon 21 L858R point mutation (L858R), exon 21 L861Q point mutation (L861Q), exon 18 G719X point mutations (G719X, including G719C, G719S, G719A) were 43.4%, 48.1%, 1.7% and 6.8%, respectively. Exon 20 T790M point mutation (T790M) was detected in 3 squamous carcinomas and 3 adenocarcinomas and exon 20 insertion mutation (20-ins) was detected in 2 patients with adenocarcinoma. Our results show the rates of EGFR mutations are higher in all types of NSCLC in Chinese patients. 19-del and L858R are two of the more frequent mutations. EGFR mutation detection should be performed as a routine postoperative examination in Chinese NSCLC patients.

Highlights

Lung cancer remains the leading cause of cancer morbidity and mortality in males, comprising 17%of the total new cancer cases and 23% of the total cancer deaths
The present study was intended to improve our understanding about the epidermal growth factor receptor (EGFR) mutation status in non-small cell lung cancer (NSCLC), especially in non-adenocarcinoma
Our results showed that the overall frequency of tyrosine kinase inhibitor (TKIs) sensitive EGFR mutations was 33.7%, and the EGFR mutation rate in squamous-cell carcinoma (14.5%), adenocarcinoma (52.9%) and adenosquamous carcinoma (39.5%) was higher than the data from previous Asian population-based studies [2,6,7,8,9,13]

Summary

Introduction

Lung cancer remains the leading cause of cancer morbidity and mortality in males, comprising 17%. Of the total new cancer cases and 23% of the total cancer deaths. Lung cancer is the fourth most commonly diagnosed cancer and the second leading cause of cancer death. The mortality burden for lung cancer accounts for 11% of the total female cancer deaths, as high as the burden for cervical cancer [1]. Surgery is the predominant approach for treatment of lung cancer, in combination with other approaches depending on the disease status. In recent years, targeted drug treatment has become a highlight for lung cancer, especially with the use of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs). Targeting EGFR is a promising strategy for the treatment of non-small cell lung cancer (NSCLC)

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