Abstract
Objective:This paper aims to study the mutation of epidermal growth factor receptor (EGFR) gene in fresh cytological specimens from patients with lung adenocarcinoma, and to determine the prognosis of positive patients by tyrosine kinase inhibitor (TKI). Methods: A total of 313 specimens from needle aspiration and pleural effusion were collected in the Cancer Detection Center of the Fourth Hospital of Hebei Medical University. After HE and immunocytochemistry stainings, the specimens were diagnosed as lung adenocarcinoma by two cytology pathologists. The
mutation of 18-21 exon was detectied using ARMS to observe mutations situation. Then, the objective response rate (ORR) and the progression-free survival (PFS) between the targeted group and the chemotherapy group of patients were comparedith. Results: Among 313 cases, 293 cases of lung adenocarcinoma were diagnosed, and DNA specimens were extracted from 288 cases. The success rate was about 98.3%. 130 mutations were found and the rate was 45.1%. EGFR mutation of adenocarcinoma patients mainly occurred to females, nonsmokers, but had nothing to do with age. The ORR was statistically different between the targeted group with chemotherapy (P<0.01), and PFS curve of targeted group was on chemotherapy group. The efficacy and the survival time of targeted group and targeted and chemotherapy group were superior to that of chemotherapy group. The results of the EGFR mutation and the prognosis of the tested positive patients in the fresh cytology samples were consistent with that from previous literatures. Conclusion: The results of the test
were accurate, and fresh cytological specimens can be used as a replacement for tumor tissue specimens.