Analysis of the relationship between the peripheral blood neutrophil-to-lymphocyte ratio and the mutation types of EGFR in patients with advanced non-small cell lung cancer / 中国基层医药

ABSTRACT

Objective:To investigate the relationship between neutrophil-to-lymphocyte ratio(NLR) and the type of epidermal growth factor receptor(EGFR) mutation and clinical characteristics in patients with advanced non-small cell lung cancer(NSCLC).Methods:From January 2017 to July 2019, the hematological detection, gene detection and clinical characteristics of 192 EGFR-mutant patients of advanced NSCLC in the Second Hospital of Wuxi Affiliated to Nanjing Medical University were collected and reviewed.The peripheral blood NLR and clinical characteristics in patients with different types of EGFR mutation.(including exon 19 and 21 mutation) were compared.Results:In this study, there were 192 NSCLC patients with EGFR mutation, including 90 patients with EGFR mutation in exon 19(46.87%), aged (67.7±12.8)years old; 84 patients with EGFR mutation in exon 21(43.75%), aged (66.6±9.3)years old; 18 patients with other types of EGFR mutation(9.38%), aged (72.5±10.5)years old.The average age of patients with other types of EGFR mutation was relatively older compared with those in exon 19 or 21 mutation, but there was no statistically significant difference( F=2.90, P>0.05). The patients with EGFR exon 19 mutation were more likely to occur in the right side(48/90) compared with EGFR exon 21 mutation(54/84), and there was statistically significant difference between the two groups(χ 2=5.45, P<0.05). However, the average NLR was (3.98±4.02) in patients with mutation in exons 19, (3.29±1.63) in patients with mutation in exons 21, and (5.32±3.48) in patients with other types of mutations.Compared with the average NLR in exon 21 mutation, the average NLR in patients with non 19 and 21 common mutations was relatively higher, but there was no statistically significant difference( F=3.51, P>0.05). According to the median NLR of 2.9, all cases were divided into two groups NLR≤2.9 was low NLR group(99 cases), and NLR>2.9 was high NLR group(93 cases). There were statistically significant differences in sex, smoking history, pathological type, eastern cooperative oncology group (ECOG) score, brain metastasis, pleura metastasis and carcinoembryonic antigen(CEA) level between high and low NLR groups(χ 2=4.52, 9.01, 10.05, 9.07, 5.89, 9.03, 19.53, all P<0.05). However, there were no statistically significant differences in age and bone metastasis between high and low NLR groups(χ 2=1.56, 1.51, all P>0.05). Conclusion:Sex, smoking history, pathological type, ECOG score, brain metastasis, pleura metastasis and CEA levels are correlated with NLR level in advanced NSCLC patients.There is certain reference value of the primary focal site in distinguishing EGFR mutation types.However, there is no correlation between NLR level and EGFR mutation type.