Investigation Of EGFR Gene Mutation In Lung Squamous Cell Carcinoma And The Effect Of EGFR-TKI Treatment On Advanced EGFR Mutation

Background:Lung cancer is one of the most common malignant tumor in our country,it is the mortality of malignant tumors in our country in the first place,in recent years,as environmental pollution factors make morbidity the morbidity increasing year by year.More than ten years with the rapid development of genetic engineering technology and related continuously research and development of targeted therapy drugs,has moved to the era of targeted therapy of lung cancer.Epidermal growth factor receptor complex amino acid kinase inhibitors(epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI)is one of the most mature and important in small cell lung cancer targeted therapy method,in each big guidelines have been recommended for sensitive EGFR mutations in the first-line treatment of patients,clinical application has more mature the treatment targeted drugs have(such as Iressa),Erlotinib(tarceva),icotinib(Conmana),Oce(Tagg Reiss),etc.TKIs representatives of the widely used drugs to target in clinical treatment,open the NSCLC targeting new stage of treatment,there are a number of large phase Ⅲ[1-3]clinical study results confirmed the presence of EGFR mutations in non-small cell lung cancer(non-small cell lung cancer,NSCLC)should be used for patients with first-line gefitinib and erlotinib for Nigeria,Oce imatinib TKIs has good clinical efficacy and safety,efficiency of 70%～85%,PFS up to 8～13 months.Squamous cell carcinoma of the lung in NSCLC after the incidence of lung cancer,but the study found that the benefit of TKI drugs in the treatment of patients with adenocarcinoma of the crowd is often,due to EGFR gene mutation rate is low,the difficulty of data collection makes the related research of 20%-30%SQCLC NSCLC is relatively backward.Squamous cell lung cancer targeted therapy has become a hot topic in NSCLC research field,has provided more choices for survival benefit in advanced lung squamous cell carcinoma patients,the incidence of EGFR mutation in domestic and abroad there are still different reports,how to effect EGFR sensitive mutations in advanced lung squamous cell carcinoma after application of EGFR-TKI,there is a big controversy.We are on the recurrence of lung squamous cell carcinoma after radical resection and postoperative metastasis or tumor tissues for the detection of EGFR gene mutation,EGFR analysis of biological characteristics of these patients with squamous cell carcinoma of lung;analysis and Discussion on the application of molecular targeted drugs in patients with advanced squamous cell carcinoma of the lung in the treatment of value.To verify the effect of targeted therapy in patients with advanced squamous cell carcinoma of the lung.Objective:To study,1 lung squamous cell carcinoma after operation and postoperative recurrence and newly diagnosed stage IV lung squamous cell carcinoma patients after the detection of EGFR gene mutation,to investigate the relationship between EGFR gene mutations and the clinical and pathological characteristics.2,observation of EGFR sensitivemutant gene in advanced lung squamous cell carcinoma patients receiving targeted drug gefitinib survival period,survival and toxicity of drug free,after treatment,to study the relationship between clinical and pathological factors.Methods:the 1 Affiliated Hospital of Qiingdao University from November 2010 to February 2016 were collected in Department of thoracic surgery diagnosed with primary lung cancer tissue samples from 89 cases of amplified refractory mutation system(amplification refractory mutation system,ARMS)of cancer EGFR gene mutation detection,to investigate the mutation of EGFR gene in lung squamous cell carcinoma specimens,gender,and age,smoking,histological type and pathological factors such as contact.2 in our hospital from July 2011 to January 2016 by IV in 24 cases diagnosed by pathological examination(7th edition staging)or postoperative recurrence of patients with squamous cell carcinoma of lung.Detection of EGFR gene mutation is found in sensitive and accept to gefitinib as first-line treatment,observation and analysis of curative effect of gefitinib,EGFR mutations in advanced squamous cell lung cancer patients,to explore the relationship between efficacy and age,smoking,differentiation,target mutation type,ECOG etc..SPSS22.0 software was used for statistical analysis.The data were tested by T and chi square test was used to test the unordered count data.P<0.05 is the standard of difference significance.Results:11 cases(12.35%)of EGFR gene mutations were detected in the biopsy tissues and wax blocks of the lung cancer,and the mutation of the gene was found in the exons of the 5 exon in the case of the mutation in the nineteenth exon.2 cases of exon twenty-first L858R mutation,2.24%of the total,1 cases of exon twenty-first L861Q mutation,accounting for 1.12%of the overall,1 cases of exon eighteenth G719X mutation,1 cases of exon twentieth S768I mutation,1 cases of exon twenty-first and exon 19 L858R mutation box in the absence of polynucleotides,each accounted for 1.12%of the total.Percutaneous lung biopsy in 20 cases were detected in 1 patients,EGFR mutation rate was 5%;bronchoscopic biopsy tissue of 8 cases were detected in 1 cases of EGFR mutation rate was 12.5%;lymph node biopsy in 1 cases,no detection of EGFR mutation;postoperative pathological paraffin sections of 59 cases of 9 cases were detected EGFR mutation detection.The rate is 15.25%.At the end of follow-up,24 patients with advanced lung squamous cell carcinoma treated with gefitinib were followed up.The follow-up data were complete,CR was performed in patients,and PR was found in all the patients(SD)in 8 patients(n = 33.3%)and PD(n = 2).RR was 54.2%,DCR was,median PFS was 6.3(0.5-17)months,with a median survival rate of 16.7%and a median OS of 15.7 months.The adverse reaction is more on class I and II,skin rash,diarrhea,dry skin and itching.Conclusion:1 the mutation rate of EGFR gene mutation in patients with lung squamous cell carcinoma was higher in female and non-smoking group,but there was no statistical significance.2.EGFR-TKI(gefitinib)on the part of the existence of EGFR survival benefit in patients with squamous cell carcinoma of the sensitive mutation is obvious,but with gender,smoking and other clinical features have no obvious relationship,EGFR-TKI for the treatment of mild adverse reactions,improve the quality of life of patients with advanced lung squamous cell carcinoma and prolong the survival period.Although the rate of EGFRmutation in patients with lung squamous cell carcinoma is relatively lower than that of adenocarcinoma,the detection of EGFR gene in patients with advanced lung squamous cell carcinoma should be performed in order to provide better individualized treatment for patients who can benefit from it.