Analysis Of Gene Mutation In 100 Cases Of Lung Adenocarcinoma After Operation And Its Clinical Significance

Research background and Objective:Lung cancer is one of the most malignant tumors with the fastest growth in morbidity and mortality and the greatest threat to people's health and life.Its morbidity and mortality are rising rapidly,and it has now leapt to the top of various malignant tumors.Non-small cell lung cancer is the most common type of lung cancer,accounting for 80%-85% of lung cancer.The onset of lung cancer is concealed,the degree of malignancy is high,and the typical clinical symptoms are lacking in the early stage.Most patients are in the middle and advanced stage at the time of treatment.The 5-year survival rate is only 16.7%,and the prevention and treatment of lung cancer is imminent.The aim of this study was to detect differences in eight driver gene changes,including EGFR,ALK,BRAF,and ERBB2,in patients with non-small cell lung cancer,and to guide clinical individualized treatment.Methods:The histopathological specimens of 100 patients with lung adenocarcinoma in the Department of Cardiothoracic Surgery,the First Affiliated Hospital of Nanchang University from January 1,2017 to December 31,2018,were collected.The clinical data of 100 patients were collected,including gender,age,and smoking.History and lymph node metastasis rate.All patients were tested by multiple generation(EGFR,ALK,ROS1,BRAF,ERBB2,etc.)using the second generation Sequencing method,and the data were statistically analyzed.Results:1.In 100 cases of lung cancer,46 cases(46%)of EGFR gene mutations were detected;15 cases(15%)of KRAS gene mutations;7 cases(7%)of ALK gene fusion mutations;5 cases(5%)of ERBB2 gene mutations;There were 4 cases of BRAF mutation(4%);3 cases of RET gene mutation(3%0);2 cases of MET and ROS1mutations(2%0);16 cases(16%)of mutated genes were not detected,but no more Acase in which a gene mutation is driven to coexist.2.A total of 56 patients with gene mutations were detected in 61 patients with lung adenocarcinoma with lymph node metastasis,including 34 EGFR mutations,5ALK mutations,12 KRAS mutations,BRAF and MET mutations.2 cases,1 case of ERBB2 gene mutation;5 cases of no mutations were detected.In 39 patients with lung adenocarcinoma without lymph node metastasis,28 patients with gene mutations were detected,including 12 EGFR gene mutations,4 ERBB2 gene mutations,and 3KRAS and RET mutations;ALK,There were 2 cases of BRAF and ROS1 gene mutations;11 cases were not detected.Conclusion:1.The EGFR gene mutation rate was highest in lung adenocarcinoma patients,followed by KRAS and ALK genes.2.genetic testing of patients after lung cancer resection can bring benefits,and non-smoking,female lung adenocarcinoma patients benefit the most.3.EGFR gene mutation in women,non-smoking as the dominant population;ALK gene mutation has no significant correlation with gender and smoking history;KRAS gene mutation is related to smoking habits,the KRAS gene mutation rate of smoking patients is much higher than non-smoking patients.4.Although BRAF,ERBB2,MET,RET,ROS1 and other genes have low mutation rate,they have important value in judging the prognosis of NSCLC.It is recommended to carry out routine detection with EGFR,KRAS and ALK.5.The detection rate of driver gene mutation rate in patients with advanced lung adenocarcinoma with lymph node metastasis is higher than that in patients with early-stage lung adenocarcinoma without lymph node metastasis.The difference is statistically different.