Mahmud Talha, Idrees Muhammad, Rafique Shazia, Abbas Rabbia, Anwar Iqra, Saqib Muhammad, Talha Hala, Mehmood Muntaha, Kashif Hadia
Pulmonary Medicine, Shaikh Zayed Federal Postgraduate Medical Institute, Lahore, PAK.
National Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, PAK.
Cureus. 2024 Sep 18;16(9):e69631. doi: 10.7759/cureus.69631. eCollection 2024 Sep.
Objective In this study, we sought to elucidate the relationship between demographic and clinical factors and epidermal growth factor receptor tyrosine kinase (EGFR-TK) positivity in patients with advanced-stage lung cancer at a tertiary care center in Pakistan. Methods This analytical cross-sectional study was conducted from February 2020 to July 2023 at Shaikh Zayed Hospital, Lahore, Pakistan, in collaboration with the Centre of Excellence in Molecular Biology (CEMB), University of the Punjab. The study included 70 consecutive patients with advanced-stage lung cancer, and aimed to identify common EGFR mutations (Exon 19 deletion and Exon 21 L858R mutation), determine their frequency, and correlate EGFR-TK mutation positivity with clinical and non-clinical factors. Tissue acquisition and processing involved bronchoscopy, pleuroscopy, or percutaneous ultrasound-guided lung mass biopsy, followed by molecular analysis using polymerase chain reaction (PCR) extraction, amplification, and sequencing. The study employed convenient sampling and included adults aged over 18 years with histologically confirmed lung cancer. Results We enrolled 70 lung cancer patients, with a mean age of 60.87 years, and a male-to-female ratio of 1.4:1. The majority (61.4%) had adenocarcinoma, and 34.3% harbored a mutant EGFR-TK. EGFR mutations were more common in adenocarcinoma (91.7%) and associated with female non-smokers. Binary logistic regression analysis revealed that age <50 years and adenocarcinoma type were significant predictors of EGFR mutations. We found no significant associations with gender, smoking status, or other variables. These findings have implications for personalized treatment approaches in lung cancer patients. Conclusions Our study reveals a high frequency of occult EGFR mutations (Exon 19 deletion and Exon 21 L858R mutation) in non-small cell lung cancer (NSCLC) patients, particularly among male smokers and female non-smokers. These findings emphasize the importance of routine EGFR mutation testing to identify patients who may benefit from targeted therapies, ultimately improving treatment outcomes.
目的 在本研究中，我们试图阐明在巴基斯坦一家三级医疗中心，晚期肺癌患者的人口统计学和临床因素与表皮生长因子受体酪氨酸激酶（EGFR-TK）阳性之间的关系。方法 这项分析性横断面研究于2020年2月至2023年7月在巴基斯坦拉合尔的谢赫·扎耶德医院与旁遮普大学分子生物学卓越中心（CEMB）合作开展。该研究纳入了70例连续的晚期肺癌患者，旨在识别常见的EGFR突变（外显子19缺失和外显子21 L858R突变），确定其频率，并将EGFR-TK突变阳性与临床和非临床因素相关联。组织获取和处理包括支气管镜检查、胸膜镜检查或经皮超声引导下肺肿块活检，随后使用聚合酶链反应（PCR）进行提取、扩增和测序的分子分析。该研究采用便利抽样，纳入了年龄超过18岁且经组织学确诊为肺癌的成年人。结果 我们纳入了70例肺癌患者，平均年龄为60.87岁，男女比例为1.4:1。大多数（61.4%）患有腺癌，34.3%携带突变的EGFR-TK。EGFR突变在腺癌中更常见（91.7%），且与女性非吸烟者相关。二元逻辑回归分析显示，年龄<50岁和腺癌类型是EGFR突变的显著预测因素。我们未发现与性别、吸烟状况或其他变量有显著关联。这些发现对肺癌患者的个性化治疗方法具有启示意义。结论 我们的研究揭示了非小细胞肺癌（NSCLC）患者中隐匿性EGFR突变（外显子19缺失和外显子21 L858R突变）的高频率，特别是在男性吸烟者和女性非吸烟者中。这些发现强调了常规EGFR突变检测对于识别可能从靶向治疗中获益的患者的重要性，最终改善治疗结果。
