Analysis of Clinical and Laboratory Data in Lung Adenocarcinoma with Activating Endothelial Growth Factor Receptor (EGFR) Mutation
Eshkol, Nir |
Recenzentas / Reviewer | |
Komisijos pirmininkas / Committee Chairman | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member |
Title: analysis of clinical and laboratory data in lung adenocarcinoma with activating endothelial growth factor receptor (EGFR) mutation.
Aim: To analyse the clinical and laboratory data in lung adenocarcinoma with activating endothelial growth factor receptor (EGFR) mutation.
Objectives:
- To establish the prevalence of lung adenocarcinoma with EGFR activating mutation in Kaunas clinics in the years 2020-2021.
- To describe the clinical characteristics (stage, age during diagnosis, gender, smoking status) in the groups of patients with mutated type (MT) EGFR gene and wild type (WT) gene.
- To compare clinical and laboratory data of patients with I-II and III-IV stage of disease.
- To describe and compare laboratory test results (Hb, WBC, LYM, Bilirubin, AST, ALT, and PLT) in lung adenocarcinoma patients with WT EGFR gene and MT EGFR gene.
Methodology: This research was performed at the Department of pulmonology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics. A retrospective analysis of the data was performed, encompassing patients who were diagnosed with histologically confirmed various stage lung adenocarcinoma during the period of 2020-2021 years. 120 patients were included in the study. Subjects were divided to those with a mutated type (MT) EGFR mutation and those with a wild type (WT) EGFR gene. The incidence of EGFR mutation, clinical characteristics and laboratory data were described and compared. The statistical analysis was performed using “SPSS” (Statistical Package for the Social Science), version 28.0 and Microsoft Excel 2013. The statistical significance chosen for the tested hypotheses was 0.05.
Results: Out of an overall sample size of 120 patients, 13 patients without a known EGFR status were excluded from the study. 24 had a MT EGFR gene while 83 had a WT EGFR gene. Among the 24 MT EGFR patients mutations were located on the 19 exon (n=11), 21 exon (n=8), 20 exon (n=4) and in 1 patient MT EGFR was found in both 19 and 21 exons. Mean age during diagnosis with MT EGFR for men was 68.9 years for men and 66.4 years for women. Statistically significant dependence on gender and smoking was confirmed: MT EGFR was more common in women (men- 41.7%, women- 58.3%) and non-smokers (smokers- 23.5%, non-smokers- 58.5%, past-smokers- 17,6%) while WT EGFR was more common in smoking men. Blood analysis showed significantly higher numbers of WBC and PLT in bigger tumour size, when metastatic disease and a more progressive stage of disease was confirmed. EGFR MT patients presented with a significantly lower lymphocyte count. No significant correlations between any other lab data mean values and EGFR status were found. Conclusions: - During the period of 2020-2021 years most patients diagnosed with lung adenocarcinoma had a WT EGFR. Patients with MT EGFR had most commonly a 19th exon mutation.
- Significantly more non-smoking women were diagnosed with MT EGFR lung adenocarcinoma, while more smoking men had WT EGFR lung adenocarcinoma diagnosis.
- When the more advanced stage of the disease was established, significantly higher numbers of PLT and WBC were detected.
- LYM number was significantly lower in patients with MT EGFR compared to WT EGFR.
Tikslas: Ištirti pacientų sergančių plaučių adenokarcinoma klinikines ir laboratorines charakteristikas esant endotelio augimo faktoriaus (EGFR) geno mutacijai. Plaučių vėžį skatinančių mutacijų atradimas pastaruoju laiku leido ženkliai patobulinti šios agresyvios ligos gydymo taktiką. Viena dažniausiai pasitaikančių mutacijų yra endotelio augimo faktoriaus (EGFR) geno mutacija, ypatingai jaunesnių nerukančių pacientų tarpe. Ji tapo reikšmingu gydymo taikiniu. Šis tyrimas aprašo bei palygina pagrindines klinikines charakteristikas bei laboratorinių tyrimų duomenis esant ir neesant EGFR geno mutacijai. Rezultatai: 83 pacientams nenustatyta EGFR mutacijos, 24 nustayta, 13 pacientams EGFR statusas nežinomas. Daugiausiai mutacijų nustayta 19 egzone. Aptiktos statistiškai reikšmingos sąsajos tarp mutacijos buvimo ir moteriškos lyties bei nerūkymo. Trombocitų ir leukocitų skaičius reikšmingai padidėjęs esant pažengesnei ligos stadijai (T3-4, M1). Limfocitai reikšmingai sumažėję esant EGFR mutacijai.