Clinicopathological Research Of EGFR Expression In Lung Adenocarcinoma

Background:Lung cancer has always been a major public health problem that has plagued the whole world.The number of deaths due to lung cancer has jumped to the top of malignant tumors,which is a serious threat to human health.In recent twenty years,the constituent ratio of adenocarcinoma in lung cancer has been increasing.It has been pointed out that the incidence of lung adenocarcinoma has been catching up with other pathological types of lung cancer,such as squamous cell carcinoma and so on,and has gradually become the most common pathological type.With the rapid development of gene detection technology and targeted drug therapy,the precise diagnosis and treatment of lung adenocarcinoma has been paid more and more attention.Currently,the most studied is Epidermal Growth Factor Receptor(EGFR)in lung adenocarcinoma.The mutation rate of EGFR gene in lung adenocarcinoma is significantly higher than that in other pathological types of lung cancer.Therefore,molecular targeted therapy for EFGR signaling pathway has become an important treatment for patients with advanced lung adenocarcinoma.However,mutations in the EGFR gene acquisition,detection of tumor tissue,the operator and laboratory demanding,China carried out within the scope of gene mutation detection and the detection area is limited,the high cost of clinical hospitals in most underdeveloped areas or in developed areas to improve.Objective:To study the expression of epidermal growth factor receptor(EGFR)in lung adenocarcinoma and its relationship between EGFR expression and clinicopathological features and prognosis.Methods:The clinical and pathological characteristics of 126 cases,selected in Zhangjiagang city first people’s hospital between June 2013 and June 2014 diagnosedas primary lung cancer after operation,have been retrospectively analyzed.There were no other serious basic diseases and no antitumor treatment.These cases were comprised of 8 adenocarcinoma in situ(AIS),32microinvasiveadenocarcinoma(MIA)and 86 invasive adenocarcinoma(ADC).General information of all patients(sex,age,TNM staging,tumor diameter,pathogenesis,etc.)have been reviewed.All patients were followed-up by telephone till 3years after the surgery.Collection of patients to remove cancer tissue in the operation(cuneiform pneumonectomy,lobectomy).The expression of epidermal growth factor receptor(EGFR)of all cases was measured as control by immunohistochemical method while EGFR gene mutation was detected by PT-PCR.Results:(1)There were notable differences among AIS,MIA and ADC patients including parameters as sex,age,TNM stage,tumor size,EGFR gene mutation and EGFR expression(P<0.05).(2)The 1-year disease-free survival rates of AIS,MIA and ADC patients were 100.00%,93.75% and 83.72%,respectively.The 1-year overall survival rates were 100.00%,100.00% and 90.70% respectively.The 3-year overall survival rates of AIS,MIA and ADC patients were 75.00%,62.50% and 58.14% respectively,and the 3-year overall survival rates were 75.00%,65.63% and 65.12% respectively.There were statistically significant differences in the 1 and 3 years of disease-free survival rates and overall survival rates in patients with AIS,MIA and ADC(P<0.05).(3)By Cox’s proportional hazards analysis age,TNM stage,EGFR gene mutation and histological typing were considered an independent factor of lung adenocarcinoma(P<0.05).Conclusion:(1)Compared to AIS and MIA patients,patients with ADC were usually older men with higher TNM stage,bigger tumor size,higher EGFR gene mutation rates and EGFR expression.(2)The prognosis of AIS,MIA and early invasive adenocarcinoma patients was better than ADC patients(P<0.05).(3)Age,TNM stage and EGFR gene mutation are the prognostic factors of lung adenocarcinoma,and the international new classification system is helpful to the prognosis of patients with lung adenocarcinoma.