Abstract
The aim of the present study was to investigate the mutation rate of the epidermal growth factor receptor (EGFR) in non-small cell lung cancer (NSCLC) patients and to apply logistic regression analysis to investigate the factors associated with EGFR gene mutation to provide data for the treatment of NSCLC. Paraffin tissue, bronchoscopy or pleural effusion specimens were collected from 176 NSCLC patients following pathological diagnosis. The EGFR gene exon 19 delL747-S75linss and delL747-S752ins deletion mutations, and the exon 20 T790M and exon 21 L858R mutations were identified using amplification refractory mutation system analysis. The clinical data and laboratory results of the patients were collected, and the total mutation rate of the EGFR gene in exons 19, 20 and 21 in the 176 NSCLC patients was found to be 48.3% (85/176). In addition, the EGFR gene mutation rate in adenocarcinoma was found to be significantly higher than that in squamous cell and large cell carcinoma (χ2=12.454; P=0.002). Furthermore, the mutation rate was found to be significantly higher in females than in males (χ2=13.78; P=0.001). The rate of exon 19 mutation was 21.0% (37/176), whereas the rate of exon 20 T90M mutation was 1.7% (3/176) and that of exon 21 L858R mutation was 29.0% (51/176). The logistic regression analysis revealed that the female gender, adenocarcinoma, distant metastasis and chemotherapy are factors associated with EGFR gene mutation (P<0.05). The female gender resulted in an increased incidence (2.438 times that of males) of EGFR mutation. Similarly, adenocarcinoma, distant metastasis and chemotherapy exhibited an increase in EGFR mutation risk (by 2.571, 2.810 and 0.367 times, respectively). The rate of EGFR mutation was high in the NSCLC patients, predominantly in exons 21 and 19. Therefore, these factors (female gender, adenocarcinoma, distant metastasis and chemotherapy) may increase the probability of EGFR gene mutations.
Highlights
Lung cancer‐related mortality is the highest among all the cancer types, and its incidence is gradually increasing [1]
The associated single factors were used to perform non‐conditional logistic regression analysis, and the results revealed that gender [X1; P=0.011; odds ratio (Exp) (B)=2.423; 95% confidence interval (CI) for Exp (B)=1.27‐4.799], pathological type [X2; P=0.039; Exp (B)=0.388; 95% CI for Exp (B)=0.158‐0.953], distant metastasis [X6; P=0.004; Exp (B)=2.798; 95% CI for Exp (B)=1.383‐5.658] and chemotherapy [X10; P=0.006; Exp (B)=0.364; 95% CI for Exp (B)=0.176‐0.752] are the predominant risk factors associated with epidermal growth factor receptor (EGFR) mutation
The results revealed that the female gender results in an increased incidence (2.438) of EGFR mutation
Summary
Lung cancer‐related mortality is the highest among all the cancer types, and its incidence is gradually increasing [1]. The treatment of cancer depends predominantly on cytotoxic chemotherapy, the efficacy in the majority of solid tumors remains extremely limited and marked toxic side‐effects have been identified, in patients with lung cancer [4,5,6]. The early detection of lung cancer is not easy and patients are often diagnosed in the middle or late stages of lung cancer and the opportunity for surgical treatment is missed and the conventional drugs for chemotherapy exhibit limited effects. Early detection of the EGFR mutation rate and its associated factors in lung tumors may present an important reference to individualize clinical treatment and improve treatment implementation in lung cancer, as well as to reduce the toxicity
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