Effect of epidermal growth factor receptor gene mutation on clinical pathology and clinical effect of tyrosine kinase inhibitor in non-small cell lung cancer / 实用医学杂志

Objective To explore the effect of epidermal growth factor receptor (EGFR) gene mutation on clinical pathology of non-small cell lung cancer (NSCLC) and clinical efficacy of tyrosine kinase inhibitor (TKI) treatment. Methods 460 NSCLC patients who were treated in our hospital from January 2017 to December 2017 were selected in this study. Based on types of mutations, they were divided into mutant positive group (129 cases) and mutant negative group (331 cases). The mutant positive group was further divided into TKI target treatment group (72 cases) and chemotherapy group (57 cases). All patients in the mutant negative group received chemotherapy (331 cases) treatment. Finally, the relationship between the EGFR gene mutation and clinical pathology was analyzed, and the progression-free survival (PFS) among groups of TKI therapy, chemotherapy of mutant positive group and chemotherapy of mutant negative group was compared. Results (1) It was found that the mutation of EGFR gene in NSCLC patients was closely related to the sex, smoking, pathological type, degree of differentiation, and serum carcinoembryonic antigen (CEA) level (P < 0.05). (2) The ORR and DCR in patients treated with TKI were significantly higher than those in other patients with positive gene mutation (P < 0.05). (3) The ORR and DCR in the EGFR mutant negative group were significantly higher than those in the EGFR mutant positive group (P < 0.05). (4) The PFS were significantly different among all groups (P<0.05) : (201.65±20.81) d in TKI group; (116.53 ± 11.61) d in chemotherapy of mutant positive group and (167.59 ± 11.46) d in mutant negative group. Conclusions The mutation of EGFR gene in NSCLC patients occurs more frequently in women, nonsmokers, adenocarcinoma, and those whose serum CEA ≥ 5 ng/mL.TKI therapy can effectively prolong the PFS in patients with EGFR positive mutation. However, it's more effective to use chemotherapy for patients without EGFR positive mutation.

EGFR mutations detection in non-small cell lung cancer liquid based cytology samples by ARMS method / 临床与实验病理学杂志

Purpose To explore the application and characteristics of liquid-based cytology samples of non-small cell lung cancer for detection of EGFR mutations by ARMS method.Methods The positive samples of liquid-based cytology were collected and the DNA of samples was extracted to detect the EGFR mutations by ARMS method and the analyze the association with clinical features,types of samples,pathological types and the contents of tumor cells,etc.Results There were 117 genetic mutations detected in 279 liquid-based cytology specimens,with the mutation rate of 41.9％.The mutation rate of adencarcinoma was 44.7％ and the other was 11.3％.When the tumor ceils in cytology samples were abundant,medium,small clusters and few,EGFR gene mutation rate were 53％,44％,45％ and 44％ respectively.19Del was 51.9％.Exon 21L858R missense mutation occurred at 39.4％ of EGFR mutations.Conclusion All liquid-based cytology of non-small cell lung cancer samples are adequate for EGFR mutation analysis.In the tumor cell-rich samples EGFR gene mutation rate is higher than that of the less tumor cells samples.19Del is the most common type of EGFR mutations.

Relationship between the epidermal growth factor receptor gene mutation and malignant pulmonary focal ground-glass lesion / 中国胸心血管外科临床杂志

@#Objective    To analyze the relationship between the epidermal growth factor receptor(EGFR) gene mutation and malignant pulmonary focal ground-glass lesion (fGGL). Methods    We retrospectively collected the clinical data of 86 patients with surgical treatment in the department of cardiothoracic surgery of Changzheng Hospital from August 2012 to February 2015. There were 26 males and 60 females with a mean age of 56.14±10.55 years. We analyzed the relationship between the EGFR gene mutation and the related clinical data. Results    Postoperative pathology showed atypical adenomatous hyperplasia (AAH) combined with focal adenocarcinoma in situ (AIS) or AIS in 10 patients, minimally invasive adenocarcinoma (MIA) in 15, and lepidic predominant adenocarcinoma (LPA) in 61. The EGFR gene mutation reports showed the exon 19 19-del mutation in 14 patients, exon 21 L858R mutation in 27, and exon 21 L861Q mutation in 2. There was no difference between the mutation of EGFR gene and clinical factors except age and smoking (P>0.05). Till June 30, 2015, all patients were alive and follow-up was 440.48±186.61 days. Conclusion    The EGFR gene in patients with malignant pulmonary fGGL shows a higher mutation rate, which provides important clinical reference data for the basic research and the clinical treatment.

Relationship between serum carcinoembryonic antigen and EGFR mutation in recurrent non-small cell lung cancer / 实用医学杂志

Objective To investigate the relationship of epidermal growth factor receptor (EGFR) mutation with clinical features of baselines as well as serum CEA level in patients with recurrent non-small cell lung cancer (NSCLC). Methods A total of 54 patients with first recurrence of advanced lung cancer who had received chemotherapy were included in this study. ADx-ARMS was performed to detect EGFR gene mutations in surgical specimens taken from the primary tumor. Serum CEA level was measured by the electrochemical luminescence method. Results The mutation rate of EGFR was significantly higher in females than in males (χ2= 11.868, P =0.006), with a total mutation rate of 60.8%in 106 patients. The rate was higher in adenocarcinoma than in other histological types(χ2=6.002,P=0.014), and significantly higher in non-smokers than in smokers (χ2= 8.502,P=0.004) and in the patients with serum CEA level over or equal to 5.0 ng/mL than those with CEA level less than 5.0 ng/mL (χ2=22.543,P=0.000). A multivariate analysis revealed that a higher serum CEA level at the time of disease recurrence was associated with EGFR gene mutations (P = 0.002). Conculsions Serum CEA level is closely associated with the presence of EGFR gene mutations in patients with first recurrence of advanced NSCLC. A higher serum CEA level at the time of disease recurrence is independently associated with EGFR gene mutations. CEA level can be used as a potential indicator to determine EGFR mutation.