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Distribution of EGFR gene mutations of early stage non-small cell lung cancer

LI Yong1, LI Zi-ming2, LU Shun2   

  1. 1.Department of Respiratory, North Hospital of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201821, China; 2.Shanghai Lung Tumor Clinical Medical Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
  • Online:2014-04-28 Published:2014-05-13

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Abstract:

Objective To explore the distribution of EGFR mutations in the early stage of non-small cell lung cancer (NSCLC). Methods Specimens from primary tumors of patients with NSCLC treated by radical surgeries in Shanghai Chest Hospital from June 1, 2003 to June 1, 2011 were collected. The EGFR mutations were detected by the PCR amplification and direct sequencing methods. The clinical pathological features between patients with EFGR sensitive mutations and patients with non EGFR sensitive mutations were compared by the chi-squared test. The correlation between EGFR sensitive mutations and clinical pathological features was analyzed by the logistic regression method. Results Among 165 patients with NSCLC, 93 cases were wild-type EGFR (56.36%，93/165); 72 cases were EGFR mutations (43.64%，72/165); and 56 cases (33.94%,56/165) were sensitive mutations (33 cases of 19del and 23 cases of 21L858R point mutation). The sensitive mutations accounted for 77.78% of all mutations (56/72). The single factor analysis showed that EGFR sensitive mutations were more frequently found in patients with adenocarcinoma, no smoking, positive EGFR fluorescent in situ hybridization (FISH) amplification, and the diameter of primary tumor less than 5 cm. Logistic regression analysis showed that the pathological type and size of primary tumor were independent prediction factors of sensitive mutations for patients with early stage NSCLC. The probability of mutations of patients with adenocarcinoma and lesion diameter less than 5cm was 4.435 times (95%CI 1.209-16.273, P=0.025) and 4.343 times (95%CI 1.393-13.540, P=0.011) than those of patients with non-adenocarcinoma or lesion diameter greater than or equal to 5 cm, respectively. Conclusion Among the patients with early stage NSCLC, the probability of sensitive mutations of those who with adenocarcinoma, no smoking, primary lesion diameter less than 5 cm, and positive EGFR FISH amplification is higher. The pathological type and size of primary tumor are independent prediction factors of sensitive mutations for patients with early stage NSCLC.

Key words: non-small cell lung cancer, early stage, epidermal growth factor receptor, gene mutation