Liam Chong-Kin, Leow Hwong-Ruey, How Soon-Hin, Pang Yong-Kek, Chua Keong-Tiong, Lim Boon-Khaw, Lai Nai-Lang, Kuan Yeh-Chunn, Pailoor Jayalakshmi, Rajadurai Pathmanathan
Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia E-mail :
Asian Pac J Cancer Prev. 2014;15(1):321-6. doi: 10.7314/apjcp.2014.15.1.321.
Mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) in non- small cell lung cancer (NSCLC) are predictive of response to EGFR-targeted therapy in advanced stages of disease. This study aimed to determine the frequency of EGFR mutations in NSCLCs and to correlate their presence with clinical characteristics in multiethnic Malaysian patients.
In this prospective study, EGFR mutations in exons 18, 19, 20 and 21 in formalin-fixed paraffin-embedded biopsy specimens of consecutive NSCLC patients were asessed by real-time polymerase chain reaction.
EGFR mutations were detected in NSCLCs from 55 (36.4%) of a total of 151 patients, being significantly more common in females (62.5%) than in males (17.2%) [odds ratio (OR), 8.00; 95% confidence interval (CI), 3.77-16.98; p<0.001] and in never smokers (62.5%) than in ever smokers (12.7%) (OR, 11.50; 95%CI, 5.08-26.03; p<0.001). Mutations were more common in adenocarcinoma (39.4%) compared to non-adenocarcinoma NSCLCs (15.8%) (p=0.072). The mutation rates in patients of different ethnicities were not significantly different (p=0.08). Never smoking status was the only clinical feature that independently predicted the presence of EGFR mutations (adjusted OR, 5.94; 95%CI, 1.94- 18.17; p=0.002).
In Malaysian patients with NSCLC, the EGFR mutation rate was similar to that in other Asian populations. EGFR mutations were significantly more common in female patients and in never smokers. Never smoking status was the only independent predictor for the presence of EGFR mutations.
非小细胞肺癌（NSCLC）中表皮生长因子受体（EGFR）酪氨酸激酶结构域的突变可预测疾病晚期对EGFR靶向治疗的反应。本研究旨在确定马来西亚多民族患者中NSCLC的EGFR突变频率，并将其存在情况与临床特征相关联。
在这项前瞻性研究中，通过实时聚合酶链反应评估了连续NSCLC患者福尔马林固定石蜡包埋活检标本中第18、19、20和21外显子的EGFR突变情况。
在总共151例患者中的55例（36.4%）NSCLC中检测到EGFR突变，女性（62.5%）比男性（17.2%）更常见[比值比（OR），8.00；95%置信区间（CI），3.77 - 16.98；p<0.001]，从不吸烟者（62.5%）比曾经吸烟者（12.7%）更常见（OR，11.50；95%CI，5.08 - 26.03；p<0.001）。与非腺癌NSCLC（15.8%）相比，腺癌中突变更常见（39.4%）（p = 0.072）。不同种族患者的突变率无显著差异（p = 0.08）。从不吸烟状态是唯一独立预测EGFR突变存在的临床特征（校正OR，5.94；95%CI，1.94 - 18.17；p = 0.002）。
在马来西亚NSCLC患者中，EGFR突变率与其他亚洲人群相似。EGFR突变在女性患者和从不吸烟者中明显更常见。从不吸烟状态是EGFR突变存在的唯一独立预测因素。
