Expression Of EML4-ALK Gene In Patients With Non Small Cell Lung Cancer With Clinical Characteristics And Survival Relations

Objective: Lung cancer is one of the most common malignant tumors in theworld, the statistical data shows that its incidence increased year by year,it has beenreported that the incidence and mortality of lung cancer are in the first place ofmalignant tumors. And along with the pathogenesis of cancer and biological behaviorof deepening, more and more scientists and clinical doctors focus on the treatmentof high specificity, mild adverse reaction of molecular targeted drugs includingEGFR-TKI which worldwide recently has been made more great effect in treatmentof NSCLC，especially in advanced NSCLC.And the discovered EML4-ALK fusiongene is another high activity of tyrosine kinase, ALK kinase inhibitor has been shownto inhibit EML4-ALK fusion gene positive cell growth. The purpose of thisexperiment was to study the EML4-ALK mutation in NSCLC, and its relationshipwith the clinical features, survival, so as to provide good basis for individualtreatment, and prognosis of patients with non small cell lung cancer.Methods: The82cases of NSCLC patients were collected in Fujian MedicalUniversity Affiliated Union Hospital since2010October to2013November, whowere confirmed by pathology. Meet after pathological diagnosis, complete detectionof EML4-ALK gene mutation in82cases. The clinical data was collected, includingage,sex,smoking history, pathological type, tumor metastasis, clinical staging orpostoperative staging and EGFR mutation status etc,and their survival situationthrough the follow-up of reading case, telephone follow-up.Results:1. The number of the initial diagnosis of NSCLC parallel detection of geneEML4-ALK is82. There were44males,38females; age36-82years, mean age60.51±10.24years old; no smoking history in53cases,29cases of patients with smoking history;20cases of I stage, II stage3cases,23cases in stage III,36cases in stage Ⅳ patients.61cases ofadenocarcinoma, squamous cell carcinoma accounted for14cases, large cell carcinomaaccounted for1case, other types accounted for6cases. EML4-ALK gene mutation have9cases. 2.The mutation rate between in male patients (6.8%) and femalepatients (15.8%) had no significant difference (P=0.291). The mutation rate between60years of age or older patients and age <60years is proved no significantdifference (P=0.782). The smoking rate of mutation(0%) and not smoking rate(17%)were statistically significant(P=0.023).The mutation rate (13.1%)of adenocarcinoma、squamous cell carcinoma、large cell carcinoma gene and othertypes is13.1%、90%、0%、16.67%,respectively,but there were no greatly significantdifferences between the four groups (P=0.782). The presence of tumor metastasisgene mutation rate (11.67%) and the absence of that (9.1%) showed no significantdifference (P=0.737).Stage I gene mutation rate (10%),stage II gene mutationrate (0%), stage III gene mutation rate (13%),stage IV gene mutation rate (11.1%), butthere were no significant differences between the four(P=0.846).The mutation rate ofEGFR+group (2.6%) and EGFR-group (18.2%) was significant differences (P=0.033).3. This study was until April30,2014, a total of9patients were lost to follow-up, heremaining patients had complete follow-up data, were followed up for6-37months, there were29cases of death, including4case of EML4-ALK genemutation and25cases in no gene mutation group. Two groups of overallsurvival time were respectively23months (95%CI,22-24months) and21months (95%CI,18-24months), P=0.769,they are no statistical difference.Colusions:1.the experiments were done in82cases of NSCLC patients with EML4-ALK fusiongene detection, including9cases of mutation, the mutation rate was10.97%,in whichdouble site mutation in3cases, specific for E13; A20mutation in9cases, E6;A20in1cases, E20; A20mutation in2cases.2.EML4-ALK fusion gene mutation tend to women, not smoking, and no mutationof EGFR gene in adenocarcinoma patients. Age, the disease stage and the tumor metastasis are no statistical difference between EML4-ALK fusion gene mutation ornot.3.EML4-ALK fusion gene mutation is not as an independent factor in evaluatingthe prognosis of non small cell lung.