To Investigate The EGFR Mutation And Beclin-1 Expression In Non-Small Cell Lung Cancer Patients With Advanced And Its Relationship With The Treatment Effect Of Gefitinib

Objective:To investigate the EGFR mutation and Beclin-1 expression in non-small cell lung cancer patients and its relationship with the treatment effect of gefitinib.It provide certain experiment basis for clinical application.Methods:75 non-small cell lung cancer patients(ⅢB,Ⅳ)treated in Wuxi NO.2 People’s Hospital from March 2012 to September 2014 were selected as the research objects.The EGFR gene of 66 adenocarcinoma cancer patients were detected.44 patients with mutant type EGFR gene were treated with gefitinib as the first-line treatment drug.22 patients with wild type EGFR gene,could not tolerate surgery or chemotherapy,therefore gefitinib was used as the first-line treatment drug.9 squamous cell carcinoma cancer patients were treated with gefitinib,because the patient was too old(>75)and refused to accept chemotherapy.Cancer tissues were collected under CT-guided percutaneous needle aspiration biopsy of the lung.The expression of Beclin-1 protein in adenocarcinoma and squamous cell carcinoma was detected by immunohistochemical method.Fasting peripheral venous blood was collected,and the supernatant was gathered after centrifugation.EGFR gene mutation was detected by DNA direct sequencing method or ARMs method.After 6 months of treatment,the treatment effect was evaluated by the solid tumor’s effect evaluation criterion.Patients were followed up,OS and PFS were recorded,and the final follow-up time was July 2016.All of the patients were killed,to follow up the deadline.Results : 1.The positive expression rate of Beclin-1 in adenocarcinoma was significantly higher than that in squamous cell carcinoma(68.18% vs 33.33%,P<0.05).2.After 6 months of treatment,the treatment effect of adenocarcinoma was significantly higher than that of squamous cell carcinoma(Z=2.381,P < 0.05).The treatment effect of adenocarcinoma and squamous cell carcinoma with Beclin-1 positive expression was significantly higher than that of Beclin-1 negative expression(Z=2.043,2.014,P<0.05).The expression of Beclin-1 was positively correlated with the treatment effect(r=0.631,P<0.05).3.The PFS and OS of patients with Beclin-1 positive expression were 8.3(4.3-10.3)months and 21.3(8.9-42.1)months,respectively.The PFS and OS of patients with Beclin-1 negative expression were 7.1(3.7-8.4)months and 17.5(5.3-33.9)months,respectively.The PFS and OS of patients with Beclin-1 positive expression were significantly higher than that in patients with Beclin-1 negative expression(χ2=2.341,5.537,P<0.05).The expression of Beclin-1 was positively correlated with PFS and OS(r=0.614,0.648,P<0.05).4.The positive expression rate of Beclin-1 in adenocarcinoma with mutant EGFR was significantly higher than that in adenocarcinoma with wild EGFR(81.82% vs 40.91%,P<0.05).The expression of Beclin-1 was positively correlated with EGFR mutation(r=0.714,P<0.05).5.The PFS and OS of adenocarcinoma patients with mutant EGFR and Beclin-1 positive expression were 9.2(5.4-10.3)months and 24.6(12.8-42.1)months,respectively.The PFS and OS of adenocarcinoma patients with mutant EGFR and Beclin-1 negative expression were 8.1(5.4-9.8)months and 19.7(10.1-36.3)months,respectively.The PFS and OS of patients with mutant EGFR and Beclin-1 positive expression were significantly higher than that in patients with mutant EGFR Beclin-1 negative expression(χ2=3.136,5.169,P<0.05).The PFS and OS of adenocarcinoma patients with wild EGFR and Beclin-1 positive expression were 5.9(4.5-9.4)months and 14.3(7.4-27.5)months,respectively.The PFS and OS of adenocarcinoma patients with wild EGFR and Beclin-1 negative expression were 5.7(3.7-8.4)months and 10.2(5.3-23.4)months,respectively.The PFS and OS of patients with wild EGFR and Beclin-1 positive expression were significantly higher than that in patients with wild EGFR Beclin-1 negative expression(χ2=3.025,4.731,P<0.05).6.The PFS and OS of squamous cell carcinoma patients with Beclin-1 positive expression were 6.4(4.3-8.1)months and 21.3(10.9-38.3)months,respectively.The PFS and OS of squamous cell carcinoma patients with Beclin-1 negative expression were 5.2(3.7-6.0)months and 17.9(8.7-34.8)months,respectively.The PFS and OS of patients with Beclin-1 positive expression were significantly higher than that in patients with Beclin-1 negative expression(χ2=2.514,3.369,P<0.05).7.The mutation of EGFR gene(P=0.000,95%CI 1.093-2.735)and Beclin-1 protein(P=0.000,95%CI 1.143-2.839)were independent risk factors that affect the OS of patients.The mutation of EGFR gene(P=0.000,95%CI 1.135-2.963)and Beclin-1 protein(P=0.000,95%CI 1.143-2.839)were independent risk factors that affect the OS of patients.Conclusion:1.The positive expression rate of Beclin-1 in adenocarcinoma is significantly higher than that in squamous cell carcinoma.2.The positive expression rate of Beclin-1 in adenocarcinoma with mutant EGFR is higher than that of the adenocarcinoma with wild EGFR.The mutation of EGFR gene is positively correlated with the expression of Beclin-1.3.The treatment effect of gefitinib on patients with Beclin-1 positive expression is superior to the patients with Beclin-1 negative expression.The treatment effect on adenocarcinoma patients with mutant EGFR and Beclin-1 positive expression is the best,which can significantly prolong the survival time.4.The mutation of EGFR gene and Beclin-1 protein are independent risk factors that affect the survival of patients.