The Relationship Of EGFR Mutations, Amplification And Disease Progression In Advanced Non-small Cell Lung Patients

Background and objectiveLung cancer according to histopathology science can be divided into non-small cell lung cancer(NSCLC, non-small cell lung cancer) and small cell lung cancer(small cell lung cancer), non-small cell lung cancer accounts for about 80% of all lung cancer, small cell lung cancer accounts for about 20% of all lung cancer. While small cell lung cancer with a high degree of malignancy, multiply fast, and appears early metastasis, surgical treatment chance, but it is sensitive to both radiotherapy and chemotherapy in the initial stages of treatment can be significantly alleviated, and the 5-year survival rate was high. Compared with small cell lung cancer, non-small cell lung cancer cell growth and division cycle is longer, and its occurrence of proliferation and metastasis of a late time. However, because of this, non-small cell lung cancer is not easy to be found early, about 75% of patients with non-small cell lung cancer found in the late, and it have missed the best opportunity for surgical treatment when it was found. Non-small cell lung cancer is less sensitive to radiotherapy and chemotherapy than small cell lung cancer, and the 5 year survival rate of non-small cell lung cancer is lower. Fortunately, through unremitting efforts, people developed a targeted therapy(EGFR-TKI) for epidermal growth factor receptor EGFR.Tyrosine kinase inhibitors(TKI) are the most representative compounds that can effectively inhibit the tyrosine kinase activity in recent years. The development of epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI) has brought the gospel to the majority of patients with non-small cell lung cancer. Patients with advanced non-small cell lung cancer can be used as first-line drug. EGFR-TKI is effective in killing tumor cells by binding to the EGFR mutation sites on the tumor cells. In clinical trials, we found that the EGFR-TKI response in patients with different types of mutations is different, there is a significant difference in the progression of the disease. Also it has a large number of studies have confirmed that, EGFR gene overexpression also with non-small cell lung cancer disease progression, invasion and metastasis has a close relationship, and on epidermal growth factor receptor tyrosine kinase inhibitor therapy is of guiding significance. The relationship of EGFR mutations, amplification and disease progression in advanced non-small cell lung patients who uses first-line oral EGFR-TKI treatment is still worth studying. Materials and Methods1. The clinical data of this topic were collected from 132 patients with EGFR gene mutation of the Second Affiliated Hospital of Zhengzhou University from January 1 of 2010 to December 31 of 2014. Among them, there were 3 patients with exon 20 mutations, because the number of patients with too little, so they do not as a comparative analysis of the object. The comparative analysis was mainly for 129 patients with 19 and 21 exon mutations. Among the 129 patients with EGFR gene mutation, 106 cases were detected by EGFR fluorescence in situ hybridization, all of the 129 patients were treated with oral TKIs EGFR as first-line therapy. Pathological samples were taken from the bronchoscopy biopsy or lung biopsy.2. Define the research object Deifne the research object according to the inclusion criteria and exclusion criteria..3. Statistics the tesingt results of EGFR gene mutation and EGFR gene amplification.4. Statistics disease progression Divided into the rapid progress of disease and the non- rapid progress of disease according to the outcome measures.5. Statistical analysis using SPSS 19 software for statistical analysis of the sample data. Used statistical methods has x2, when P<0.05, we think it has a statistically significant difference. Results1. In 132 cases of study, there are 3 patients with EGFR gene exon 20 mutations, and the three patients capita rapid progress in 3 months. Because the sample size is too small, so they were not as a comparative analysis of the object, but can be used as a reference index.2. Mutation of exon 19 and exon 21 of EGFR gene occurred much more in non- smoking female lung adenocarcinoma patients under 59 years of age, and peripheral lung cancer is more than central type lung cancer.3. EGFR gene amplification occurred much more in non-smoking female lung adenocarcinoma patients under 59 years of age, and peripheral lung cancer is more than central type lung cancer.4. There was significant difference of the distribution frequency in disease progression between mutation of exon 19 and exon 21 of EGFR gene, and the difference was statistically significant(P<0.05). The rapid progression of disease is more likely to occur in patients with exon 21 of EGFR gene than in patients with exon 19 of EGFR gene.5. There was significant difference of the distribution frequency in disease progression between EGFR gene amplification and not amplification, and the difference was statistically significant(P<0.05). The rapid progression of disease is more likely to occur in patients with EGFR gene not amplification than in patients with EGFR gene not amplification.6. There was significant difference of the distribution frequency in gene amplification status between mutation of exon 19 and exon 21 of EGFR gene, and the difference was statistically significant(P<0.05).The EGFR gene amplification is more likely to occur in patients with exon 19 of EGFR gene than in patients with exon 21 of EGFR gene. Conclusions1. EGFR gene Mutation and gene amplification occurred much more in non-smoking female lung adenocarcinoma patients with young age, and peripheral lung cancer is more than central type lung cancer.2. The EGFR gene amplification is more likely to occur in patients with exon 19 of EGFR gene than in patients with exon 21 of EGFR gene.3. In patients with advanced non-small cell lung cancer in the first line of oral administration of EGFR-TKI, the rapid progression of disease is more likely to occur in patients with exon 21 of EGFR gene and EGFR gene not amplification.