The Study Of EGFR Mutations And ALK Rearrangements In Chronic Obstructive Pulmonary Disease Patients With Lung Adenocarcinoma

Objective:To investigate the expression of driving mutations in chronic obstructive pulmonary disease(COPD)patients with lung adenocarcinoma and evaluate the related factors.Methods: Clinical data from the 101 patientswith histologically proven lung adenocarcinoma in the study who were admitted to the second hospital of Lanzhou University between January 2015 and January 2017 were analyzed retrospectively.The patients were divided into COPD group and non-COPD group according to the results of lung function.The patients' clinical characteristics were collected,including age,gender,height,weight,smoking history and initial tumor staging,etc.EGFR mutations of the patients were detected by polymerase chain reaction-Sanger direct sequencing and ALK rearrangements of the patients were detected by reverse transcription-polymerase chain reaction combined with Sanger sequencing.T-test and Chi-square test were used to evaluate whether the driver mutations and other clinical characteristics were different between the COPD group and non-COPD group.The Spearman rank test was used to analyze the association between severity of airflow obstruction and EGFR mutations,ALK rearrangements.logistic regression analysis was used to estimate the relationship between driver mutations and other clinical variables.Results:(1)101 lung adenocarcinoma patients were enrolled,44 patients(43.6%)were diagnosed as COPD,24 patients(23.8%)had EGFR mutations and 18 patients(17.8%)had ALK rearrangements,the expression of EGFR mutations and ALK rearrangements in COPD group were lower than non-COPD group(EGFR: 6.8% vs.36.8%,P<0.01.ALK: 4.5% vs.28.1%,P<0.01).(2)logistic regression analysis showed that EGFR mutations were more common in female,non-smokers and non-COPD patients(P<0.05),ALK rearrangements were more common in younger,male,non-smokers and non-COPD patients(P<0.05).(3)Spearman rank test results showed that the expression of EGFR mutations and ALK rearrangements decreased as airflow obstruction increased(EGFR: r=-0.372,P<0.01.ALK: r=0.314,P<0.01).(4)Among never smokers,the prevalence of EGFR mutations were lower than those in non-COPD group(23.1% vs.63.3%,P<0.05),but the difference in the prevalence of ALK rearrangements between the two groups had no statistical significance(15.4% vs.33.3%,P>0.05).Conclusions:The prevalence of EGFR mutations were associated with gender,smoking history and COPD.ALK rearrangements were associated with gender,age,smoking history and COPD.The prevalence of EGFR mutation and ALK rearrangement were negatively correlated with the severity of airway obstruction.