Study On The Relationship Between The Expression Level Of MiR-221 In Peripheral Blood And The Acquired Resistance Of The First Generation Of EGFR-TKIs In Lung Cancer

BackgroundLung cancer is one of the most common malignant tumors,with a high morbidity and mortality rate,of which 80% is non-small cell lung cancer.The first representative skin growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs),represented by gefitinib,have achieved good clinical effects,but drug resistance problems are inevitable.The expression of miR-221 is obviously up-regulated in a variety of cancers,especially in lung cancer,the change of miR-221 expression can promote tumor cell invasion and metastasis.So,is the resistance phenomenon of lung cancer patients to a generation of EGFR-TKIs(gefitinib,icotinib,erlotinib)related to the abnormal expression of miR-221 in peripheral blood? These questions are currently unanswered.PurposeObserve the changes in the expression of miR-221 in peripheral blood of patients with EGFR-mutated lung cancer receiving first-generation EGFR-TKIs,and explore the correlation between miR-221 and acquired resistance of first-generation EGFR-TKIsMethodThe research subjects selected 73 patients with advanced non-small cell lung cancer who were treated at the First Affiliated Hospital of Xinxiang Medical College and received a generation of EGFR-TKIs from October 2017 to October 2019.Fluorescence quantitative PCR technology was used to detect the expression level of miR-221 in the peripheral blood during drug administration,and to analyze its relationship with clinical pathological parameters,first-generation EGFR-TKIs resistance and prognosis.Result1.According to miR-221 expression level,it was divided into high expression group and low expression group.Analysis of the relationship between the high and low expression of miR-221 in peripheral blood and the clinicopathological data of NSCLC patients.It was found that the high expression of miR-221 was related to the tumor TNM stage,and the difference was statistically significant(P <0.05),but was related to gender and age,EGFR gene mutation site,lymph node metastasis,distant metastasis are not related(P> 0.05)The expression level of miR-221 in the serum of drug-resistant patients had no relationship with the clinicopathological parameters such as gender,age,tumor location,EGFR mutation site,lymph node metastasis,and drug resistance(local progression,distant metastasis).2.According to miR-221 expression level,it was divided into miR-221 high expression group and miR-221 low expression group.The median disease-free survival time(PFS)of miR-221 high expression group was 6 months.The median progression-free survival time(PFS)of miR-221 low expression group was 12.6 months.PFS in the high expression group and PFS in the lower expression group were short,p <0.05,the difference was statistically significant.3.Univariate Cox regression analysis of the correlation between PFS and different clinicopathological parameters(gender,age,EGFR gene mutation site,lymph node metastasis,distant metastasis,tumor TNM stage,miR-221 expression)showed that miR-221 was Expression and tumor TNM stage(T3-T4)are all risk factors leading to shorter PFS in NSCLC patients.4.Analysis of the relationship between miR-221 expression in peripheral blood during drug resistance and different clinicopathological parameters(gender,age,drug resistance,tumor site,T790 M mutation),the results showed that miR-221 in peripheral blood during drug resistance None of the above clinical pathological parameters were correlated,and the difference was not statistically significant.5.Fluorescence quantitative PCR results showed that with the increase of medication time,the expression level of miR-221 in peripheral blood showed a gradual upward trend.ConclusionFluorescence quantitative PCR results showed that with the increase of medication time,the expression level of miR-221 in peripheral blood showed a gradual upward trend.