Volume 43 Issue 2
Mar.  2022
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Maofang WU, Yongchun ZHOU, Jingjing CAI, Xin MO, Yinwei LI, Jiahui MAO. EGFR Gene Mutation State and Its Clinical Significance in Multi-nodular Lung Adenocarcinoma in Yunnan Province[J]. Journal of Kunming Medical University, 2022, 43(2): 60-66. doi: 10.12259/j.issn.2095-610X.S20220215
Citation: Maofang WU, Yongchun ZHOU, Jingjing CAI, Xin MO, Yinwei LI, Jiahui MAO. EGFR Gene Mutation State and Its Clinical Significance in Multi-nodular Lung Adenocarcinoma in Yunnan Province[J]. Journal of Kunming Medical University, 2022, 43(2): 60-66. doi: 10.12259/j.issn.2095-610X.S20220215

EGFR Gene Mutation State and Its Clinical Significance in Multi-nodular Lung Adenocarcinoma in Yunnan Province

doi: 10.12259/j.issn.2095-610X.S20220215
  • Received Date: 2021-12-13
    Available Online: 2022-02-24
  • Publish Date: 2022-03-04
  •   Objective  To investigate the relationship between EGFR gene mutations and clinicopathological characteristics of patients with multinodular lung adenocarcinoma in Yunnan province by using NGS method.   Methods  A total of 111 pulmonary nodule samples from 79 patients with multifocal lung adenocarcinoma were collected between January 2018 to May 2020 in the Molecular Diagnostic Center of Yunnan Cancer Hospital. The NGS method was used to detect the EGFR mutation of multiple lung nodules to analyze its relationship with clinicopathological characteristics, and Logistic regression to analyze its independent risk factors.   Results  The total EGFR mutation rate in 111 lung nodule tissue samples was 58.55% (65/111), among which L858R point mutation and exon 19 deletion were the most common, accounting for 53.8%of the total mutations (35/65).The rare mutation rate was 27.02% (30/111), the single point mutation rate was 37.84% (42/111), and the compound mutation rate was 20.72% (23/111). χ2 test showed that females, age ≥56 years, non-smoker, areas with a high incidence of lung cancer in Yunnan, earlier pathological stages (stages Ⅰ to Ⅱ), and invasive adenocarcinoma had a higher EGFR gene mutation rate, and the difference was statistically significant (P = 0.036、P = 0.001、P < 0.001、P = 0.006、P = 0.006、P = 0.034).Multivariate Logistic regression analysis showed thatage ≥56 years, non-smoker, areas with a high incidence of lung cancer in Yunnan, and earlier pathological stages (stages Ⅰ to Ⅱ) are independent risk factors for EGFR gene mutations (P<0.05).The heterogeneity rate of EGFR gene expression between paired nodules in the same patient was as high as 87.5% (28/32).  Conclusions  Among patients with multinodular lung adenocarcinoma in Yunnan, the elderly, non-smoker, areas with a high incidence of lung cancer in Yunnan, and earlier pathological stages (stages Ⅰ to Ⅱ) are independent risk factors for EGFR gene mutations.The high-level heterogeneity of driver mutations among the lesions of patients with multinodular lung adenocarcinoma suggests that multiple nodules tend to be independent of the origin of the primary tumor, which will provide more options for the diagnosis and treatment of multinodular lung adenocarcinoma.
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