| Objective In this study,high-throughput sequencing was used to detect the mutations of common driving genes(EGFR,ALK,KRAS,BRAF,ROS1,RET,HER2,MET)in patients with non-small cell lung cancer(NSCLC),to analyze the correlation between these mutations and clinical and pathological features,and to analyze the survival of NSCLC patients with different gene mutations,so as to provide basis for individualized treatment of NSCLC.Methods A total of 115 NSCLC patients who were treated in the Department of Oncology of Chifeng Municipal Hospital from 2019.01.01 to 2021.12.31 were collected.Next Seq CN500 was used as the main detection equipment for comprehensive detection of tumor precision treatment.The gene detection results of the patients were analyzed,and the overall positive rate of gene mutation,the mutation frequency of related driving genes,the proportion of various mutation types,common driving gene mutation sites and their co-mutation genes were analyzed.To analyze the correlation between the status of driving gene mutation and the clinical and pathological characteristics of NSCLC patients,including sex,age,smoking history,family history,ECOG score,primary site,pathological type,degree of differentiation,TMB,Napsin A,CK-7,TTF-1,sample type,metastasis site,etc.,and to analyze the survival of NSCLC patients with different gene mutation status,so as to provide a theoretical basis for further research on targeted therapy.Results Among the 115 patients with NSCLC,the mutation frequency of driving gene EGFR was the highest(55.65%),followed by ALK(9.57%),KRAS(8.70%),BRAF(6.96%),HER2(4.35%),RET(3.48%),MET(1.74%)and ROS1(0.87%).The mutation frequency of tumor suppressor gene BRCA2 and TP53 gene was 50.43% and40.87%.In this study,EGFR gene mutations occurred mostly in adenocarcinoma patients with no smoking history,and were easily detected in tissue samples,with a higher incidence of bone metastasis.ALK gene mutations were prone to meningeal and pleural metastases(P<0.05),and RET gene mutations were mostly found in CK-7positive patients.Patients with multiple gene mutations were more likely to have adrenal metastasis than patients with single gene mutations(P<0.05).The median time of PFS in patients with EGFR mutant was 16.72 months,and the median time of PFS in patients with wild type was 10.67 months.The median survival time of patients with wild type of EGFR was significantly lower than that of patients with mutant type(X~2=35.960,P<0.01),there was significant difference between the two groups.Pathological type(P=0.023),age(P=0.034),and distant metastasis(P=0.014)were risk factors for survival.Conclusion EGFR is the most common oncogenic driving gene with the highest mutation rate in NSCLC patients,followed by ALK and KRAS genes.EGFR mutations are more likely to occur in non-smokers and adenocarcinoma patients,easy to detect in tissue samples,the incidence of bone metastasis is higher;ALK gene mutations are prone to meningeal and pleural metastasis;RET gene mutations are more likely to occur in CK-7 positive patients;patients with multiple gene mutations are prone to adrenal metastasis.The median survival time of EGFR patients with wild type was significantly lower than that of patients with mutant type.Pathological type,age and distant metastasis were the risk factors affecting survival time. |
