Influence of Epidermal Growth Factor Receptor Gene Mutation Detection Results on the Choice of Clinical Targeted Therapy in Non-small Cell Lung Cancer

XU Binbin; YANG Dongjie; YIN Shan

doi:10.16458/j.cnki.1007-0893.2025.20.006

Abstract：Objective To investigate the impact of epidermal growth factor receptor(EGFR)gene mutation detection results in non-small cell lung cancer on the selection of clinical targeted therapy.Methods A retrospective selection was made of 110 patients diagnosed with non-small cell lung cancer in Xuchang People's Hospital from January 2023 to January 2024 as the research subjects.According to the results of EGFR gene mutation detection,they were divided into a detected group(51 cases)and a non-detected group(59 cases).The clinical characteristics of the two groups of patients were compared.Meanwhile,100 patients with non-small cell lung cancer admitted to Xuchang People's Hospital during the same period were selected.According to the EGFR gene mutation detection results and treatment plans,they were divided into a wild group(wild type+surgery+chemotherapy,49 cases),a mutant group(mutant type+surgery+chemotherapy,26 cases),and a targeted group(mutant type+surgery+chemotherapy+tyrosine kinase inhibitor treatment,25 cases).The clinical characteristics,toxic and side effects of chemotherapy drugs,and disease-free survival(DFS)of the three groups of patients were compared.Results Among 110 patients with non-small cell lung cancer,the mutation rate of the EGFR gene was 46.36%.The proportions of female patients,adenocarcinoma patients and well-differentiated patients in the detection group were all higher than those in the non-detection group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the composition ratios of different ages,lymph node metastasis conditions and pathological tumor-lymph node metastasis(pTNM)stages between the two groups(P>0.05).There were statistically significant differences in the composition ratio of pathological types and the DFS survival rates at 6,12,and 18 months among different patients in the targeted group,wild group,and mutation group(P<0.05).Among them,the proportion of adenocarcinoma in the targeted group was higher than that in the wild group(χ2=12.404,P<0.001).There were no statistically significant differences in the constituent ratios of different genders,ages,T stages,N stages,degrees of differentiation,pTNM stages,as well as the constituent ratios of different degrees of allergic reactions,liver and kidney damage,neurotoxins,bone marrow suppression,and gastrointestinal reactions among the three groups(P>0.05).Conclusion Females,adenocarcinoma,and an increased proportion of highly differentiated components can increase the EGFR gene mutation rate in patients with non-small cell lung cancer.For EGFR mutation-positive patients,the combination of tyrosine kinase inhibitor targeted therapy on the basis of conventional surgery+chemotherapy can significantly prolong their DFS.