Clinical Study Of EGFR Gene Status In Advanced Non-small Cell Lung Cancer

PART I The relevance of EGFR gene mutation with Pathological features an in patients with advanced non-small cell lung carcinomaObjective: To study the relevance of EGFR gene mutation with pathological features in patients with advanced non-small cell lung carcinoma.Methods: 325 patients from Janunary 2014 to December 2015 in Guangxi zhuang autonomy Hospital were chosen as objects,all of them were treated with Ampilification Refractory Mutation System to detect EGFR gene mutation.To study the relevance of EGFR gene mutation with clinical and pathological features in patients.Results: There were 122 cases with mutation in all 325 patients.The rate of EGFR mutation was37.5%.Among them,The rate of EGFR mutation at18?19?20?21 respectively was 0.8%(1/122)?46.7%(57/122)?5.8%(8/122)?41.9%(52/122).The rate of 19 exon and 21 exon in EGFR mutation accout for 88.6%(109/122).There were 203 cases of excon mutation in patients of EGFR wild type.EGFR gene mutation has no significant relevance with age and nation and clinical stage(P>0.05);the relevance between EGFR gene mutation and gender and smoking history and pathological types and differentiation cancer has satistial significance(P<0.05).The difference between prognosis of EGFR-mutat patients and that of EGFR-widepatients has statistical significance(P<0.05).Conclusion: EGFR gene mutation was common in patients who were female,non-smoking and higher degree of differentiation tumor.It was more common in patients with adenocarcinoma.And pathological features of patients were independent predictors of EGFR mutations.PART II Independent prognostic factor and survival analysis of EGFR gene mutation status in advanced non-small cell lung cancerObjective:This is a retrospective study among 122 patients with IIIB/IV by EGFR gene mutation status non-small cell lung cancer.We would like to know the median overall survivaland the median progression free survival in our hospital.What is more,we study to investigate the over all survival and the median progression free survival among the subgroups stratified by EGFR gene mutation status,independent prognostic factor.Methods: We collected the cases from Janunary 2014 to December2015 in Guangxi zhuang autonomy Hospital.There are 122 cases patients who diagnosed as stage IIIB/IV by EGFR gene mutation status NSCLC.Some information was added by telephone follow-up.The calculation of OS?PFS?objective response rate?disease control rate?univariate and multivariate survival analysis was performaned by SPSS21.0.Results:1.The overall survival by EGFR gene mutation status is12.2months;The progression free survival by EGFR gene mutation status is 6.6months.2.The overall survival in EGFR mutation patients is 14.2months,The overall survival in EGFR wild type patientsis 10.9months.The progression free survival in EGFR mutation patients is 8.76 months,in EGFR wild type patients is 5.1months.3.The EGFR-TKI most common adverse were skin rashes and diarrhea,The chemotherapy most common adverse were Bone marrow suppression and the digestive tract reaction.Objective response rate in EGFR mutation patients is 47.4%;Disease control rate in EGFR mutation patients is 81.3%;Objective response rate in EGFR wild type patients is31.5%;Disease control rate rate in EGFR wild type patients is 61.9%.4.The Kapan-meier univiate survival analysis shows statistical OS?PFS difference among the subgroups of age?sex?smoking history ? the pathologic types ? Clinical staging and treatment method.5.The cox regression of multivariate survival analysis shows the independent poor independent prognostic factors are ECOG score,two different treatment methods(EGFR wild type and EGFR mutated type).Conclusion:1.The overall survival by EGFR gene mutation status is 12.2months;The progression free survival by EGFR gene mutation status is 6.6months.2.Thedifference between prognosis of EGFR-mutat patients andthatof EGFR-wild patients has statistical significance.3.The independent prognostic factors are ECOG score,two different treatment methods(EGFR-wild type and EGFR-mutat type).