Background: At present the proportion of lung adenocarcinomas in NSCLC is higher than before. Thus, the study on prognosis of lung adenocarcinoma is extremely important. The predictive value of epidermal growth factor receptor (EGFR) mutations for prognosis in patients with resected lung adenocarcinomas has not be reported in China. The aim of this study is to analyze the association between the EGFR mutations and the outcomes of patients with resected lung adenocarcinomas.
Methods: Total of 301 patients with stage Ia-IIIa resected lung adenocarcinomas whose survival had been identified were retrospectively analyzed. Their EGFR mutations were detected by real-time quantitative PCR and DNA sequencing technology together.
Results: The proportion of EGFR mutation was 52.5% (158/301). The 2-year (disease-free survival, DFS) of EGFR-mutant group and wild-type EGFR group was 76.8%, 83.0%; 5-year overall survival (OS) of them was 67.7%, 65.7%. There was no significant difference for two groups (P = 0.252, P = 0.715). Further analysis for subgroups shows that the 2-year DFS, 5-year OS of mutant group and wild-type group in stage I-II was similar. For the patients with stage IIIa, the median DFS, 2-year DFS in mutant group was 12.2 months, 21.1%, lower than the 22.2 months, 42.1% in wild-type group. But there was no significant difference for both groups (P = 0.584, P = 0.295). The median OS, 5-year OS was 34.0 months, 30.8% in mutant group, while 38.7 months, 22.9% in wild-type group. There was no significant difference for both groups (P = 0.907, P = 0.444).
Conclusions: EGFR-mutant group with resected lung adenocarcinomas has a tendency of lower DFS than the wild-type EGFR group only in stage IIIa, but there was no significant difference for both groups. The EGFR mutation status was not associated with disease-free survival or overall survival in resected lung adenocarcinomas.
背景与目的 近年来，肺腺癌在非小细胞肺癌（non-small cell lung cancer, NSCLC）中的比例正越来越高，对肺腺癌预后的研究有着极其重要的意义。表皮生长因子受体（epidermal growth factor receptor, EGFR）突变状态是否会影响到手术切除的肺腺癌患者的复发及生存，国内尚缺乏报道。本研究旨在探讨EGFR突变状态与可手术肺腺癌的复发及生存的关系。方法 回顾性分析301例Ia期-IIIa期手术切除肺腺癌患者的复发及生存资料。采用荧光定量PCR法筛查+基因测序法确认检测EGFR基因突变状态。结果 EGFR突变率为52.5%（158/301）。EGFR突变型与野生型的2年无疾病生存期（disease-free survival, DFS）率分别为76.8%、83.0%，5年总生存期（overall survival, OS）率分别为67.7%、65.7%，皆无统计学差异（P=0.252, P=0.715）。进一步的亚组分析显示，I期、II期患者中突变型与野生型的2年DFS率、5年OS率数值相近且无统计学差异。而IIIa期患者中突变型的中位DFS、2年DFS率为12.2个月、21.1%，明显低于野生型的22.2个月、42.1%，但无统计学差异（P=0.584, P=0.295）；突变型的中位OS、5年OS率为34.0个月、30.8%，野生型为38.7个月、22.9%，无统计学差异（P=0.907, P=0.444）。结论 在可手术肺腺癌患者中，仅IIIa期患者EGFR突变型较野生型有复发早的趋势，但无统计学差异。EGFR突变状态与术后复发及长期生存无关。