The Influencing Factors Of EGFR Mutation And The Correlation Between EGFR Mutation And ERCC1 Gene Expression In Patients With Non-small Cell Lung Cancer

Objective: To investigate in EGFR mutation and ERCC1 gene ex pression in 104 patients with non-small lung cancer, the factors of infl uencing EGFR mutation and the correlation between EGFR mutation a n-d ERCC1 gene expression are investigated. It can help us to underst and deeply clinical significance of the detection of EGFR mutation.Methods: One-hundred and four patients with non-small lung cancer which were confirmed by pathological tissue, were collected from department of thoracic surgery of the fourth hospital of Hebei Medical University between July 2013 and February 2015, 89 cases of o-peration,15 cases of biopsy,40 cases of female,64 cases of male, age fro-m 28-79 years, mean age 60.5 years,53 cases of smoking,51 cases of no-smoking,34 cases with family history of tumor,70 cases with no family history of history. Classifying these case in terms of pathology,they are 73 cases of adenocarcinoma,28 cases of squamous cell carcinoma, glan-d scale cancer 1 case, adenosquamous 1 case, neuroendocrine carcino-ma 1case.Classifying these cases of operation in terms of standard TNM period of non-small lung cancer revised by IASLC2009,they areⅠperiod 40 cases,Ⅱperiod 28 cases,Ⅲ period 21 cases,38 cases of lymphatic metastasis, 51 cases of no-lymphatic metastasis. These tumor tissues of 104 patients were sent to Bei Jing Yakangbo to use ARMS to detect EGFR mutation and use real-time PCR to detect ERCC1 gene expression. All the dates are enumeration date with percentage which were analyzed with chi-square test, SPSS 13.0 and P<0.05 was considered a statistical significance for difference.Results:1 In this study, there are 43 cases of EGFR mutation in 104 patients with non-small lung cancer, mutation rate 41.3(43/104), including 19 cases of exon 19 mutation, 18 cases of exon 21 mutation, 1case of exon 20 mutation, 3 cases of exon 18 mutation, 2cases of exon 19/20 mutation.Th-e cases of exon 19/21 mutation were found in 86.1% of the total cases of EGFR mutation.2 In this study there are 40 cases of female patients,24 cases of EGFR mutation, mutation rate 60.0%(24/60) and 64 cases of male patient-s,19 cases of EGFR mutation,mutation rate 29.7%(19/64).The difference has statistical significance that EGFR mutation rate of female is high-er than EGFR mutation rate of male(χ2=9.326,P=0.002,chi-square test). There are 73 cases of adenocarcin-oma,38 cases of EGFR mutation, mutation rate 52.1%(38/73),31 cases of no adenocarcinoma,5 cases of EGFR mutation, mutation rate 16.1%(5/31).The difference has statistical significance that EGFR mutation rate of adenocarcinoma is higher than EGFR mutation rate of no adenocarcinoma(χ2=11.581, P=0.001,chi-square test).There are 34 cases of tumor family history,20 cases of EGFR mutation, mutation rate 58.8%(20/34),70 cases of no tumor family history,23 cases of EGFR mutation, mutation rate 32.9%(23/70).The difference has statistical significance that EGFR mutation rate of tumor family history is higher than EGFR mutation rate of no tumor family history(χ2=6.363, P=0.012, chi-square test). There are 51 cases of no smoking, 28 cases of EGFR mutation, mutation rate 54.9%(28/51),53 cases of no smoking,15 casesof EGFR mutation, mutation rate 28.3%(15/53).The difference has statistical significance that EGFR mutation rate of no smoking is higher than EGFR mutation rate of smoking.3 In this study, we use international TNM period to put 89 patients with non-small lung cancer which accept operative treatment divided into several groups: Ⅰperiod group,Ⅱperiod group,Ⅲperiod group. Ⅰperiod group has 41 cases, EGFR mutation 23 cases, mutation rate 56.1%(23/41). Ⅱperiod has 28 cases,EGFR mutation 10 cases, mutation rate 35.7%(10/28) andⅢ period has 20 cases,EGFRmutation6 cases,mutation r-ate 30.0%(6/20).EGFR mutation rate of three groups has no statistical difference( χ2=4.809,P=0.09,chi-square). There are 38 cases of lymphatic metastasis,14 cases of EGFR mutation, mutation rate 36.8%(14/38)and 51 cases of no lymphatic metastasis,25 cases of EGFR mutation, mutation rate 49.0%(25/51).The difference of mutation rate of two group has no statistical significance(χ2=1.312,P=0.0252,chi-square test).4 In this study, we use EGFR mutation to put these cases divided into two groups, EGFR mutation group and EGFR wild type group.EG-FR mutation group has 31 cases of ERCC1 gene low expression in 43 patients,low expression rate72.1%(31/43) and EGFR wild type group has 25 cases of ERCC1 gene low expression in 61 patients, low expression rate 41%(25/61).The low expression rate of EGFR mutation group is higher than EGFR wild type group and the difference of two groups has statistical significance(χ2=9.822,P=0.002,chi-square test).Conclusion:1 Now, the mutation rate which we use ARMS to detect EGFR mutation in our clinical work and which the literature reports are consistent.2 The EGFR mutation of non-small lung cancer, exon 19 and exon 21 mutations are prominent and the EGFR mutation rate of patients of female, adnocarcinoma, no smoking, and tumor family history is higher than the mutation rate of male, no adenocarcinoma, smoking, no tumor family history in our district.3 EGFR mutation of non-small lung cancer have no correlation with period of tumor and lymphatic metastasis.4 In non-small lung cancer, the ERCC1 gene low expression rate of the patients with EGFR mutation is higher than the patients with EGFR wild type and the patients with EGFR mutation are possibly sensitive for platinum drug.