新疆石河子地区非小细胞肺癌EGFR基因突变分析
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摘要
目的分析新疆石河子地区非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)基因突变检测情况及其与临床病理特征的关系。方法收集720例确诊为NSCLC患者(包括已行EGFR基因突变检测的239例)的完整病史资料,分析EGFR基因突变情况与病理特征的相关性。结果新疆石河子地区NSCLC患者EGFR突变检测率为38.1%。检出EGFR突变113例(47.3%);女性患者突变率(63.6%)高于男性(35.7%),两者之间差异有统计学意义(P=0.000);腺癌患者突变率(52.7%)明显高于非腺癌患者(12.5%),差异有统计学意义(P=0.000);19Del突变率为41.6%,21L858R突变率为37.2%;NSCLC患者中19Del突变在女性患者中较男性常见(P=0.001),L858R突变男女间差异无统计学意义(P=0.58);腺癌中男性19Del突变率(15.5%)低于女性(29.9%)(P=0.013),L858R突变男女差异无统计学意义(P=0.796)。结论新疆石河子地区NSCLC患者EGFR突变检测率偏低,有待提高;该地区EGFR突变主要见于腺癌,女性患者;突变类型主要为19Del及21L858R,其中女性患者19Del突变比男性多见。
Objective To analyze the relationship between epidermal growth factor receptor(EGFR) gene mutation and clinical pathological features of non-small cell lung cancers(NSCLC) in Shihezi area of Xinjiang. Methods A total of 720 patients diagnosed with NSCLC were collected(including 239 patients who had finished EGFR detection),and the relationships between EGFR gene mutation and clinicopathological features were statistically analyzed. Results The EGFR screening rate of NSCLC patients in Shihezi area of Xinjiang was 38.1%. EGFR mutations were detected in 113 cases of 239 patients with NSCLC(47.3%),The EGFR mutation rate of female patients(63.6%) was significantly higher than that of male patients(35.7%),and the difference was statistically significant(P=0.000);Moreover,the EGFR mutation rate was significantly higher in adenocarcinoma(52.7%) than that of non-adenocarcinoma patients(12.5%),and the difference was statistically significant(P=0.000);Mutations were mainly detected in exon 19 del(41.6%) and exon 21 L858 R(37.2%);In NSCLC patients,19 Del mutations were more common in women than in men(P=0.001),there was no significant difference between L858 R mutations in men and women(P=0.58);Among adenocarcinoma patients,the mutation rate of female patients with 19 Del mutation(29.9%) was higher than that of male patients(15.5%)(P=0.013),and the difference in L858 R mutation between men and women was not statistically significant(P=0.796). Conclusion The EGFR screening rate of NSCLC patients in Shihezi area of Xinjiang was low and needed to be improved;The EGFR mutations in this area were more frequently found in females,adenocarcinoma patients;the main types of mutations were exon 19 del and exon 21 L858 R mutation,among which 19 Del mutations were more common in female patients than in males.
Objective To analyze the relationship between epidermal growth factor receptor(EGFR) gene mutation and clinical pathological features of non-small cell lung cancers(NSCLC) in Shihezi area of Xinjiang. Methods A total of 720 patients diagnosed with NSCLC were collected(including 239 patients who had finished EGFR detection),and the relationships between EGFR gene mutation and clinicopathological features were statistically analyzed. Results The EGFR screening rate of NSCLC patients in Shihezi area of Xinjiang was 38.1%. EGFR mutations were detected in 113 cases of 239 patients with NSCLC(47.3%),The EGFR mutation rate of female patients(63.6%) was significantly higher than that of male patients(35.7%),and the difference was statistically significant(P=0.000);Moreover,the EGFR mutation rate was significantly higher in adenocarcinoma(52.7%) than that of non-adenocarcinoma patients(12.5%),and the difference was statistically significant(P=0.000);Mutations were mainly detected in exon 19 del(41.6%) and exon 21 L858 R(37.2%);In NSCLC patients,19 Del mutations were more common in women than in men(P=0.001),there was no significant difference between L858 R mutations in men and women(P=0.58);Among adenocarcinoma patients,the mutation rate of female patients with 19 Del mutation(29.9%) was higher than that of male patients(15.5%)(P=0.013),and the difference in L858 R mutation between men and women was not statistically significant(P=0.796). Conclusion The EGFR screening rate of NSCLC patients in Shihezi area of Xinjiang was low and needed to be improved;The EGFR mutations in this area were more frequently found in females,adenocarcinoma patients;the main types of mutations were exon 19 del and exon 21 L858 R mutation,among which 19 Del mutations were more common in female patients than in males.
引文
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[2]Yatabe Y,Kerr K M,Utomo A et al.EGFR mutation testing practices within the Asia Pacific region:results of a multicenter diagnostic survey[J].J Thorac Oncol,2015,10(3):438-445.
[3]Tsao A S,Scagliotti G V,Bunn P A et al.Scientific advances in Lung Cancer 2015[J].J Thorac Oncol,2016,11(5):613-638.
[4]Bray F,Ferlay J,Soerjomataram I et al.Global cancer statistics 2018:Globocan estimates of incidence and morality worldwide for 36 cancers in 185 countries[J].CA Cancer JClin,2018,68(6):394-424.
[5]Bremnes R M,Busund L T,Kilvaer T L et al.The role of tumor-infiltrating lymphocytes in development,progression,and prognosis of non-small cell lung cancer[J].J Thorac Oncol,2016,11(6):789-800.
[6]Wu M,Pan X,Xu Y et al.Methodological comparison of the allele refractory mutation system and direct sequencing for detecting EGFR mutations in NSCLC,and the association of EGFR mutations with patient characteristics[J].Oncology letters,2018,16(1):1087-1094.
[7]Gaur P,Bhattacharya S,Kant S et al.EGFR mutation detection and its association with clinicopathological characters of lung cancer patients[J].World journal of oncology,2018,9(5-6):151-155.
[8]Cheng Y,Wang Y,Zhao J et al.Realworld EGFR testing in patients with stage IIIB/IV non-small-cell lung cancer in North China:A multicenter,non-interventional study[J].Thoracic cancer,2018,9(11):1461-1469.
[9]Li R,Li Q,Lin S et al.Prognostic implication of EGFRmutation status and subtype in resected lung adenocarcinoma patients irrespective of therapy[J].Clin Trowsl Oncol,2019,21(3):298-303.
[10]Sun Y,Yin X,Wen M M et al.EGFR mutations subset in Chinese lung squamous cell carcinoma patients[J].Molecular medicine reports,2018,17(6):7575-7584.