Clinical Characteristics Of Lung Adenocarcinoma Gene Mutation Profile In Lanzhou Area

Objective:Analysis of patients with lung adenocarcinoma gene mutation spectrum in lanzhou and its clinical features,combing genetic mutations in lanzhou data to preliminary explore the region gene mutation ratio and type,investigate the relationship between gene mutation spectrum and clinical characteristics,improve the clinician gene mutation detection in patients with the disease knowledge and guide the necessity of accurate treatment and help patients to improve the prognosis of patients.Methods:Data of 126 patients with lung adenocarcinoma admitted to the First Hospital of Lanzhou University from January 2017 to September 2021 were divided into three groups: EGFR gene mutation group（62 cases）,Other gene mutation group（31 cases）and no gene mutation group（33 cases）.Gene mutation status of statistical research groups,comparison and analysis of three groups of patients with clinical characteristics including age,sex,smoking history,clinical symptoms,imaging examination,laboratory examination,tumor characteristics,differences of selected clinical features associated with genetic mutations,and binary Logistic regression model independent risk factors for the development of EGFR gene mutation screening.Results:1.The genetic mutation status of 126 patients with lung adenocarcinoma in the Lanzhou area was that EGFR mutation accounted for 49.21% of the total,including EGFR 19 DEL mutation（26.19%）,EGFR EXON21 L858 R mutation（16.67%）,other EGFR EXON21 mutation（3.17%）.EGFR 20INS/EXON mutation（1.59%）,Mutations were ALK（8.73%）,KRAS（8.73%）,ERBB（3.17%）,MET（1.59%）,BRAF（0.79%）,CTNNB1（0.79%）and RET（0.79%）.No gene mutation accounted for26.19%,and 12 patients（12.9%）had EGFR mutation combined with double mutation.lung adenocarcinoma patients in Lanzhou are prone to EGFR mutations,among which EGFR 19 DEL is the most common,followed by EGFR L858 R mutation.ALK mutation and KRAS mutation have similar probability and relatively more.2.EGFR mutation is commonly seen in non-smoking female patients with lung adenocarcinoma,most of whom are 50-59 years old.At the initial diagnosis,EGFR mutation is mostly in patients with advanced medium and low differentiation,Lung adenocarcinoma patients with other gene mutations were more male than female,and there were fewer smokers.The onset age was mainly 60-69 years old.Also,due to the insistence of onset,most patients were late-stage and low-differentiated patients at the initial diagnosis.3.There were statistically significant differences in MONO%,TC,LDH and CYFRA21-1 among the three groups（P<0.05）.The MONO% level of the EGFR gene mutation group was lower than that of the non-EGFR gene mutation group,while the TC level of the EGFR gene mutation group was higher than that of the non-EGFR gene mutation group.The LDH level of other gene mutation group was higher than that of the EGFR gene mutation group,CYFRA21-1 level of other gene mutation group was higher than that of no gene mutation group.If the optimal truncation value analysis of CYFRA21-1 was performed,it was found that there was statistical significance in CYFRA21-1 ≥ 2.76ng/m L between the group with other gene mutations and the group without gene mutations（P<0.017）.When CYFRA21-1 ≥2.76ng/m L,the possibility of other gene mutations was suggested.CEA optimal truncation value analysis showed that the CEA ≥ 1.69ng/m L in the EGFR gene mutation group was significantly different from that in the other two groups（P<0.017）.When CEA<1.69ng/m L,EGFR gene mutation was possible.There were significant differences in the distribution of bone metastasis,other site metastasis（adrenal metastasis,mediastinal metastasis,pericardium metastasis,renal metastasis,adnexal metastasis,spinal cord metastasis,and rare site metastasis under the scalp）and no distant metastasis in the three groups（P<0.05）.Patients with genetic mutations were more likely to develop metastases,especially bone metastases,while those with other genetic mutations were more likely to develop metastases elsewhere.?4.Multivariate analysis of EGFR gene mutation showed that CEA<1.69ng/m L and bone metastasis were positively correlated with EGFR gene mutation,and CEA<1.69ng/m L and bone metastasis were independent risk factors for EGFR gene mutation.Conclusion:1.The most common gene mutations in patients with lung adenocarcinoma in Lanzhou are EGFR mutations,among which EGFR 19 DEL is the most common,and ALK mutations are more frequent than those in most areas of China.2.EGFR mutation is common in female patients aged 50-59 in lung adenocarcinoma,and EGFR gene mutation is more likely to cause distant metastasis,especially bone metastasis,than non-EGFR gene mutation.3.Distant metastasis,especially bone metastasis,is more likely to occur with other gene mutations than without gene mutations.Other mutations were more likely to result in rare site metastases than EGFR mutations.4.Patients with lung adenocarcinoma with low MONO%,high TC and CEA<1.69ng/ml were prone to EGFR gene mutation.With high LDH and CYFRA21-1≥2.76ng/m L,other gene mutations were likely.CEA<1.69ng/m L and bone metastasis were independent risk factors for EGFR gene mutation.