Observational Study Of Current EGFR/ALK Gene Detection And Gene Mutations In 1134 Non-small Cell Lung Cancer Patients

Background and Purpose:Molecular target therapy plays an important role in advanced non-small cell lung cancer.Our study is to investigate the current detection status of EGFR/ALK gene in Chinese NSCLC patients,including the pathology type,detection method of ALK/EGFR gene,time from biopsy to pathological diagnosis,time from pathological diagnosis to confirm EGFR/ALK gene mutation status and the target treatment of patients harboring EGFR mutation/ALK rearrangement;to analysis the EGFR mutation/ALK rearrangement rate and their clinicopathologic features in order to guide clinical diagnosis and treatment.Patients and Methods:A total of advanced(stage ?B-?)1134 NSCLC patients confirmed by cytology or histology in 13 hospitals from March 2015 to April 2017 were collected.The detection methods of ALK fusion can be Ventana IHC(D5F3),ARMS,NGS or FISH,and the detection methods of EGFR mutation can be ARMS or NGS.SPSS 21.0 was used for statistical analysis.Results:the most common pathological type detected EGFR/ALK gene was adenocarcinoma;the most common detection method of EGFR and ALK genes were ARMS and Ventana IHC(D5F3),respectively;EGFR-positive patients received EGFR-TKI accounted for 73.8%,ALK-positive patients received crizotinib accounted for 51.4%,the first-line target treatment status of EGFR-positive patients were related with the time from pathological diagnosis to confirm EGFR gene mutation status;The EGFR gene mutation rate was 40.7%,gender,smoking history and age were independent factors of EGFR mutations,and patients harboring EGFR mutantion were more likely to have baseline brain metastasis;ALK rearrangement positive rate was 9.4%,the age and smoking history were independent factors of ALK rearrangement,EGFR mutation and ALK rearrangement were negatively correlated.Conclusions:In addition to adenocarcinoma,there also have EGFR mutation/ALK rearrangement in patients in other pathological types of NSCLC;The first-line targeted treatment of EGFR-positive patients were associated with the time from pathological diagnosis to confirm EGFR gene mutation status;patients harboring EGFR mutations were more likely to have baseline brain metastases.