Wang W L, Li H W, Cao J Z, Zhang X Q, Song X, Jia S F, Jia H X
Department of Radiation Oncology, Shanxi Cancer Hospital, Taiyuan 030013, China.
Zhonghua Zhong Liu Za Zhi. 2017 Oct 23;39(10):744-748. doi: 10.3760/cma.j.issn.0253-3766.2017.10.005.
To investigate the relationship between the status of epidermal growth factor receptor (EGFR) mutations and brain metastases in patients with lung adenocarcinoma. From August 2010 to May 2015, a total of 1 063 lung adenocarcinoma patients with identified status of EGFR mutations in Shanxi Cancer Hospital were enrolled, of which 456 patients had EGFR mutations. Multivariate Logistic regression model was used to analyze the correlation between EGFR mutation status and brain metastases in patients with lung adenocarcinoma. In 125 patients with brain metastases before initial treatment, 65 patients had EGFR mutations, including 36 patients with deletion mutations in exon 19. The frequency of EGFR 19 exon mutation was 28.8% (36/125). Among 456 patients with EGFR mutations, 65(14.3%) patients were with brain metastases, in which 36(55.0%) had deletion mutations in exon 19. The multivariate analysis showed that age, Eastern Cooperative Oncology Group (ECOG) score, EGFR mutations and N staging were associated with brain metastases(<0.05). Further subgroup multivariate analyses showed that age, ECOG score, mutation status in exon 19 and N staging were associated with brain metastases (<0.05). EGFR mutation status is related to brain metastases. Mutations in EGFR exon 19 is an independent risk factor for brain metastases.
探讨肺腺癌患者表皮生长因子受体（EGFR）突变状态与脑转移之间的关系。2010年8月至2015年5月，山西医科大学附属肿瘤医院共纳入1063例已明确EGFR突变状态的肺腺癌患者，其中456例患者存在EGFR突变。采用多因素Logistic回归模型分析肺腺癌患者EGFR突变状态与脑转移的相关性。在125例初始治疗前发生脑转移的患者中，65例患者存在EGFR突变，其中36例患者为第19外显子缺失突变。EGFR第19外显子突变频率为28.8%（36/125）。在456例EGFR突变患者中，65例（14.3%）发生脑转移，其中36例（55.0%）为第19外显子缺失突变。多因素分析显示，年龄、东部肿瘤协作组（ECOG）评分、EGFR突变及N分期与脑转移相关（P<0.05）。进一步亚组多因素分析显示，年龄、ECOG评分、第19外显子突变状态及N分期与脑转移相关（P<0.05）。EGFR突变状态与脑转移有关。EGFR第19外显子突变是脑转移的独立危险因素。
