Investigation On Correlation Between Epidermal Growth Factor Receptor Mutation Status And Brain Metastases Of Non-small Cell Lung Cancer

Objectives:This project was designed to identify the correlation between epidermal growth factor receptor(EGFR)mutation status and brain metastases(BM)in patients with non-small cell lung cancer(NSCLC).Methods:We retrospectively investigated the cases of NSCLC meeting included criteria at the First Affifiliated Hospital of Fujian Medical University from November 2012 to June 2019,whose EGFR status had been detected.The data was collected for patient characteristics,including age,gender,smoking status,pathological type,BM.We assessed the correlation between EGFR and clinical features,explored relationship between EGFR of NSCLC and BM.The clinical data was analyzed by SPSS 24.0.The value of two-tailed P <0.05 held statistical significance.Results:For 599 there were 336(56.1%)wild-type EGFR and 263(43.9%)EGFR mutations.Overall analysis displayed that the rate of EGFR mutation was higher in female,≥60 year-old,non-smoking and adenocarcinoma group(P-value<0.05).EGFR subtype analysis showed that the rate of EGFR exon 19 mutation was higher in female,non-smoking and adenocarcinoma group(P-value <0.05).The rate of EGFR exon 21 mutation was higher in female,≥60 year-old,non-smoking and adenocarcinoma group(P-value<0.05).The correlation analysis between BM and clinical features showed that the incidence of BM in < 60 year-old and adenocarcinoma group were higher than that in ≥ 60 year-old and non-adenocarcinoma group(P-value <0.05).The correlation analysis between EGFR gene status and brain metastasis showed that the incidence of BM in EGFR mutations was higher than that in wild-type EGFR,though without statistical significance(P=0.196).The incidence of BM in exon 18,19,20 and 21subtypes were respectively 33.33%,21.55%,25.00% and 18.18%.There was no difference in the incidence of BM between them(P=0.638).Further analyzed showed that the incidence of EGFR mutant BM was higher than that of EGFR wild type in patients ≥60 years(P=0.035).Among 107(17.86%)BM patients,neither significant difference in BM time(P=0.963),nor significant difference in BM number(P=0.357).Moreover,the results showed EGFR exon 19 mutation occurred synchronous BM higher than that in heterochronous BM and the incidence of multiple BM was higher than that in single,though without statistical significance(P-value≥0.05).And EGFR exon 21 mutation occurred synchronous BM higher than that in heterochronous BM and the incidence of multiple BM was higher than that in single,though without statistical significance(P-value≥0.05).Logistic regression analysis proved that age <60 years and adenocarcinoma were independent risk factors of BM.Conclusions:(1)The incidence of EGFR mutant BM was higher than that of EGFR wild type in patients ≥60 years.(2)There was no significant correlation between EGFR mutation status and BM,but the incidence of brain metastasis increased in patients with EGFR mutation.(3)EGFR mutation status had no significant correlation with BM time and number.(4)Age <60 years and adenocarcinoma were independent risk factors of BM.