A Variety Of Drive Gene Expression In Patients With Lung Adenocarcinoma And Clinical Analysis

Objective:To study the correlation between different mutation types and mutation rates in lung adenocarcinoma and clinical manifestations and imaging features,so as to provide a certain reference for these patients to find appropriate targeted drugs.Method:This study was approved by the Ethics Committee of the First Affiliated Hospital of Wannan Medical College.In September 2019-December 2021,in the first affiliated hospital medical school in the south of anhui for the first time to see a doctor and it broke in lung adenocarcinoma,and to accept the second generation sequencing(NGS)genetic testing of hospitalized patients with clinical data,including patient’s age,gender,in general,tumor pathologic type,gene mutation type,clinical characteristics and chest imaging characteristics,The correlation between mutation rate,clinical features and imaging features of different gene mutation types was analyzed.Results:The complete data of 106 patients were collected in this study.1.There were 81 cases of gene mutation,and the mutation rate was 76.42%(81/106).There were 25 patients without mutation,accounting for 23.58%(25/106)of the total.2.There were 54 patients with EGFR mutation,accounting for 50.94%(54/106)of the total number of patients,including 5 patients with EGFR18 P.G719A mutation,accounting for 9.26%(5/54)of the total number of EGFR mutations,and 23 patients with EGFR 19 DEL mutation,accounting for 42.59%(23/54)of the total number of EGFR mutations.There were 2 EGFR20 P.S7681 mutations(3.70%(2/54)),17 EGFR21 L858R mutations(31.48%(17/54)),and 4 EGFR20 T790M mutations.The number of EGFR mutations accounted for 7.41%(4/54),and there were 5 EGFR mutations,accounting for 9.26%(5/54).3.7 rare mutations were detected,accounting for 25.47%(27/106)of the total number of patients,including 2 BRAF gene mutations,4 HER2 gene mutations,7 KRAS gene mutations,4 RET gene mutations,3 ROS1 gene mutations,5 ALK gene mutations,and 2 MET gene mutations.Accounted for 1.89%,3.77%,6.60%,3.77%,2.83%,4.72%,1.89%of the total population in this study respectively.4.There were several subtypes of rare mutations,including 1 missense mutation of HER2 19 exon,3 insertion mutation of HER2 20 exon,6 missense mutation of KRAS 2 exon,1 missense mutation of KRAS4 exon,2 missense mutation of BRAF V600E exon,and 2 jump mutation of MET14 exon.There were 2 RET16M918T point mutations,2 RET fusion mutations,5 ALK fusion mutations,and 3 ROS1 fusion mutations,accounting for 3.70%,11.11%,22.22%3.70%,7.41%,7.41%,7.41%,7.41%,18.52%of the rare mutations,respectively.11.11%.5.EGFR mutation was more common in female patients(P=0.033),non-smoking patients(P=0.001),and patients with pleural depression(P=0.042),with all P values<0.05,which was statistically significant.Smoking history of rare mutations(P=0.002)and differentiation degree(P=0.010),P<0.05,were statistically significant.Imaging necrosis signs were more common in patients with lung adenocarcinoma with HER2 mutation(P=0.005),with P<0.05,which was statistically significant.Among KRAS mutations,elderly patients(P=0.040)and smokers(P=0.045)were more common,with all P values<0.05,indicating statistical significance.Among ALK mutations,young patients(P=0.018)with poor differentiation(P=0.008)were more common,with all P values<0.05,indicating statistical significance.ROS1 mutation,patients with lobulation(P=0.028)were more common,P<0.05,which was statistically significant.Conclusion:1.Mutations were detected in 81 of 106 patients with lung adenocarcinoma,with a mutation rate of 76.42%.2.Lung adenocarcinoma gene mutations are more common in EGFR mutations,among which EGFR19del and EGFRFR.21L858R are more common.EGFR mutation patients are mostly female and non-smoking patients,and chest CT findings often show signs of pleural depression.3.Mutation rates of BRAF,KRAS,RET,ROS1,MET,ALK and HER2 in lung adenocarcinoma were 1.89%,6.60%,3.77%,2.83%,1.89%,4.72%and 3.77%,respectively.There are also many different subtypes of rare mutations.4.Rare mutations are seen in poorly differentiated patients who smoke.The CHEST CT findings of HER2 mutations often show necrosis.KRAS mutations are common in older patients who smoke.ALK mutations are common in poorly differentiated young patients.The CHEST CT findings of ROS1 mutations often show lobulation.