Department of Oncology, Daping Hospital, Army Medical University, Chongqing, China.
Department of Cell Biology and Genetics, Chongqing Medical University, Chongqing, China.
Cancer Med. 2022 Jan;11(1):268-280. doi: 10.1002/cam4.4424. Epub 2021 Nov 19.
Risk factors vary in terms of the pattern of lung cancer metastasis and specific metastatic organs. In this study, we retrospectively analyzed the clinical risk factors of tumor metastasis in lung cancer patients and used second-generation gene sequencing to characterize relevant gene mutations. The risk factors of different metastatic sites of real-world lung cancer were explored to find the differentially expressed genes and risk factors in different metastatic organs, which laid a foundation for further study on the metastasis patterns and mechanisms of lung cancer. The clinical risk factors of tumor metastasis in 137 lung cancer patients who attended our department from May 2017 to March 2019 were retrospectively analyzed and grouped based on bone metastasis, brain metastasis, other distant metastasis, and no metastasis. Single- or multi-factor logistic regression analysis was performed to analyze the effect of neutrophil/lymphocyte ratio/platelet/lymphocyte ratio/lymphocyte to monocyte ratio on platelets (PLTs) and bone metastasis by combining PLT values, age, pathology type, gender, and smoking history. Based on the presence or absence of bone metastasis, distal metastasis, and PLT values of lung cancer, 39 tissue specimens of primary lung cancer were taken for 773 gene grouping and gene mutation characterization. The tumor mutation load, gene copy number instability, microsatellite instability, and tumor heterogeneity among different groups were analyzed. Age and PLT level were independent risk factors for bone metastasis and distal metastasis, but not for brain metastasis. The RB1 gene was mutated during bone metastasis, and tumor heterogeneity was less in the elevated PLT group. PLT values were an independent risk factor for distant metastases from lung cancer other than the brain. Age has a significant effect on bone metastasis formation. RB1 gene mutation was significantly associated with bone metastasis.
肺癌转移的模式和特定转移器官因风险因素而异。在本研究中,我们回顾性分析了肺癌患者肿瘤转移的临床风险因素,并采用第二代基因测序对相关基因突变进行了特征分析。探索了不同转移部位肺癌的风险因素,以寻找不同转移器官中的差异表达基因和风险因素,为进一步研究肺癌的转移模式和机制奠定了基础。回顾性分析了 2017 年 5 月至 2019 年 3 月在我科就诊的 137 例肺癌患者的肿瘤转移临床风险因素,并根据骨转移、脑转移、其他远处转移和无转移进行分组。采用单因素或多因素 logistic 回归分析,结合 PLT 值、年龄、病理类型、性别和吸烟史,分析中性粒细胞/淋巴细胞比值/血小板/淋巴细胞比值/淋巴细胞与单核细胞比值对血小板(PLT)和骨转移的影响。根据肺癌有无骨转移、远处转移及 PLT 值,对 39 例原发性肺癌组织标本进行 773 基因分组及基因突变特征分析。分析不同组间肿瘤突变负荷、基因拷贝数不稳定性、微卫星不稳定性及肿瘤异质性。年龄和 PLT 水平是骨转移和远处转移的独立危险因素,但不是脑转移的独立危险因素。RB1 基因在骨转移时发生突变,PLT 升高组肿瘤异质性较小。PLT 值是肺癌脑外远处转移的独立危险因素。年龄对骨转移形成有显著影响。RB1 基因突变与骨转移显著相关。