Abstract
To investigate the distribution of epidermal growth factor receptor (EGFR) mutations, and explore any relationships with clinical characteristics in non-small-cell lung carcinoma (NSCLC) patients. EGFR mutations were assessed by ADx-ARMS in 261 NSCLC patients from West China Hospital of Sichuan University. Relationships between EGFR mutation and clinical characteristics were analyzed by SPSS. The EGFR mutation rate was 48.7% (127/261), 19-del and L858R mutations occurred predominantly, accounting for 33.1% and 40.9%, respectively, in mutated cases. Moreover, 10.2% patients were found to carry double mutations. EGFR mutations occurred more frequently in women (57.5%) than in men (41.8%) (P=0.01), and were more frequent in non-smokers (61.2%) than in former or current smokers (31.2%) (P<0.00). In addition, they were more common in adenocarcinomas (52.8%) and adenosquamous carcinomas (42.8%) than in squamous cell carcinomas (14.8%) (p<0.00). However, only smoking history and pathological types, rather than gender, proved to be associated with EGFR mutations on multivariate logistic regression analysis. No significant differences in pathological stage and metastasis status were found between EGFR wild-type and mutated cases, although EGFR mutation type was related to pathological type (p=0.00) - 19-del, L858R and other mutation types respectively occurred in 34.2%, 42.5% and 23.3% of adenocarcinomas, but in 14.3%, 0% and 85.7% of non-adenocarcinomas. The EGFR mutation rate was 48.7% in NSCLCs in Southwest China, so that nearly 40% patients might benefit from targeted therapies. Smoking status and pathological types were independent predictors of EGFR mutation, while EGFR mutation type was related to only pathological type, rather than smoking status.
Highlights
Lung cancer is one of the most common cancers in the world, with sharply increasing morbidity and mortality in the last decades
epidermal growth factor receptor (EGFR) mutation status and mutation type are essential for EGFR-tyrosine kinase inhibitors (TKIs) application in non-small-cell lung carcinoma (NSCLC) patients
China is a state with vast territory and multi-nations, EGFR mutation rate varies in different regions, range from 30% to 50%
Summary
Lung cancer is one of the most common cancers in the world, with sharply increasing morbidity and mortality in the last decades. It was estimated that about 1.8 million new lung cancer cases occurred in 2012 worldwide by GLOBOCAN, occupied 13% of all cancers, with only 15% five-year survival rate. It has become the leading cause of cancer death among males in the whole world, and has surpassed breast cancer as the leading cause of cancer death among females in more developed countries (Torre et al, 2015). With the development of molecular mechanism research in lung cancer, some gene mutations and genetic recombinations were found to be involved in NSCLC pathogenesis, including KRAS, EGFR, ALK, ROS1, et al, which provided new treatment protocols, pushing NSCLC into a new era of targeted therapy (Pao and Hutchinson, 2012)
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