Bi Jianping, Han Guang, Wei Xueyan, Pi Guoliang, Zhang Yong, Li Ying, Wang Mingwei, Hu Desheng, Zhen Weining
Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan, HB, China.
Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, HB, China.
J Cancer Res Ther. 2018;14(4):799-806. doi: 10.4103/jcrt.JCRT_824_17.
We have previously demonstrated that brain metastases were more common among patients with epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma. However, the association of EGFR mutation and extracranial metastases (ECM) remains inconclusive. In this study, we explored the potential association between EGFR mutation and the risk of ECM.
Between March 2007 and December 2014, 234 patients were analyzed for the potential association between EGFR mutation and ECM.
Multivariate Cox regression analysis.
There were no associations between the EGFR mutation and metastases in different organs, except for bone. The frequency of EGFR mutation was statistically higher for patients with bone metastases (BMs) at the initial diagnosis (P = 0.039) and at the last follow-up (P = 0.018) as compared to those with wild-type EGFR. In multivariate logistic regression analysis, EGFR mutation significantly increased the risk of BM at the initial diagnosis (P = 0.036). Among those patients without BM at initial diagnosis, 1- and 2-year accumulative rates of subsequent BM were significantly higher in patients with EGFR-mutant disease (P = 0.026). EGFR mutation was an independent risk factor for subsequent BM (P < 0.05). In addition, patients with finial BM and EGFR-mutant disease had longer median survival as compared to those with wild-type disease (P = 0.020).
Only BM in patients with ECM was significantly correlated with EGFR mutation during their disease course. EGFR mutation was an independent predictive and prognostic factor for developing BM, which was also a positive predictive factor for overall survival of patients who developed BM.
我们之前已经证明，脑转移在表皮生长因子受体（EGFR）突变的肺腺癌患者中更为常见。然而，EGFR突变与颅外转移（ECM）之间的关联仍不明确。在本研究中，我们探讨了EGFR突变与ECM风险之间的潜在关联。
2007年3月至2014年12月期间，对234例患者分析了EGFR突变与ECM之间的潜在关联。
多变量Cox回归分析。
除骨转移外，EGFR突变与不同器官的转移之间无关联。与野生型EGFR患者相比，初诊时（P = 0.039）和末次随访时（P = 0.018）骨转移（BM）患者的EGFR突变频率在统计学上更高。在多变量逻辑回归分析中，EGFR突变在初诊时显著增加了BM风险（P = 0.036）。在初诊时无BM的患者中，EGFR突变型疾病患者随后发生BM的1年和2年累积发生率显著更高（P = 0.026）。EGFR突变是随后发生BM的独立危险因素（P < 0.05）。此外，与野生型疾病患者相比，最终发生BM且为EGFR突变型疾病的患者中位生存期更长（P = 0.020）。
在疾病过程中，ECM患者中只有BM与EGFR突变显著相关。EGFR突变是发生BM的独立预测和预后因素，也是发生BM患者总生存的阳性预测因素。
