| Objective:To investigate the relationship between the mutation status of PTEN and PIK3 CA gene and the clinicopathological features and prognosis of lung cancer,breast cancer,gastric cancer and colorectal cancer.Methods:This study included 414 patients admitted to the First Affiliated Hospital of China Medical University from December 2012 to April 2017.They included 238 lung cancer patients,40 breast cancer patients,109 colorectal cancer patients,27 Gastric cancer patients?Collecting tumor tissue samples and / or blood samples,extracting DNA samples of tumor tissues and blood samples according to the instruction of DNA extraction kit,purifying and separating ct DNA of the plasma samples by column chromatography and further using magnetic beads to obtain high-purity ct DNA,Tissue,blood cell DNA and ct DNA-enriched gene fragments were sequenced on a high-throughput sequencing platform after quality control.A comprehensive bioinformatics analysis platform was used to analyze the high-throughput sequencing data to obtain the tumor tissue Gene test results.The chi square test was used to analyze the relationship between PTEN,PIK3 CA gene mutation status and lung cancer,breast cancer,colorectal cancer,gastric cancer patients' gender,age,smoking history,pathological type,histological grade,lymph node metastasis,tumor T stage,ECOG score,First-line efficacy and other clinical and pathological characteristics of the relationship;Kaplan-Meier survival curve analysis of the above gene mutation status and lung cancer,breast cancer,colorectal cancer,gastric cancer patients with the overall survival;COX risk regression analysis of patients with gene mutations and clinical Effect of pathological features on overall survival.All analyzes were done using SPSS16.0 software.Results:The four major diseases were grouped according to the PTEN and PIK3 CA gene mutation status,and the gene mutation status and gender,age,smoking history,pathological type,histological grade,lymph node metastasis,tumor T stage,ECOG score,Efficacy and other clinical and pathological features of the relationship.The results showed that in patients with lung cancer,the mutation of PTEN gene showed a difference in the sex of the cancer patients(P = 0.038);the mutation occurred more frequently in male patients.The PIK3 CA gene mutation showed a significant difference in the age of patients with cancer(P = 0.043).The mutation in the PIK3 CA gene mostly occurred in patients 60 years of age or older.There was a trend in patients with ECOG score of 1(P = 0.058);In breast cancer patients,the mutation of PTEN gene tended to present in patients without lymph node metastasis(P = 0.073)and later in tumor T stage(P = 0.094).The mutation of PIK3 CA in histological grade-poorly differentiated(P = 0.06)There are trends in patients.In colorectal cancer patients: mutations in the PTEN gene present a trend in patients with tumor T stage T1-3(P = 0.06).In patients with gastric cancer,the PIK3 CA gene mutation showed no significant difference in clinical pathological features such as age,sex,histological grade,but there was a trend in patients over 60(P = 0.07).In colorectal cancer patients,wild-type PTEN had a better prognosis and a higher median survival than the mutant patients(median OS 48 months vs.7 months,P = 0.008).In patients with lung cancer,the diagnosis of more than 60 years of age,first-line efficacy is an independent prognostic factor of protection.In colorectal cancer patients,the depth of tumor invasion is an independent risk factor affecting the prognosis.Conclusion:PTEN mutations in patients with lung cancer mostly in men;PIK3CA gene mutations occur in patients older than 60 years of age,ECOG score of 1 points.The mutation of PTEN gene in patients with colorectal cancer is predominant in patients with T1-3 staging.The prognosis of PTEN wild type patients was better,and the median survival time was significantly higher than that of the mutation patients.The depth of invasion was an independent risk factor for prognosis. |
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