Analysis on clinicopathological features and prognostic influencing factors of SMARCA4-deficient non-small-cell lung cancer patients

TANG Yu; ZHANG Ping; WANG Minjie; LAN Jiaqi; LIN Bingqi

doi:10.3969/j.issn.1674-3806.2024.03.08

Abstract：Objective To analyze the clinicopathological features and prognostic influencing factors of SMARCA4-deficient non-small-cell lung cancer(NSCLC)patients.Methods The clinical data of 106 patients with SMARCA4-deficient NSCLC(SMARCA4-deficient group)and 212 patients with non-SMARCA4-deficient NSCLC(non-SMARCA4-deficient group)who were admitted to Dongnan Hospital of Xiamen University and Zhangzhou Municipal Hospital of Fujian Province from January 2016 to June 2021 were retrospectively analyzed.Survival curve was plotted by Kaplan-Meier method,and comparison between groups was performed by log-rank test.Cox regression was used to analyze the factors influencing the 2-year overall survival of the SMARCA4-deficient NSCLC patients.Results Compared with those in the non-SMARCA4-deficient group,the patients in the SMARCA4-deficient group had older age,higher proportion of male and smoking history,longer tumor diameter,higher Ki-67 index,lower proportion of EGFR mutation,lower proportion of squamous cell carcinoma,and higher proportion of poorly differentiated carcinoma,and the differences were statistically significant(P＜0.05).Among patients with SMARCA4-deficient NSCLC,95.28%(101/106)of the patients had complete deficiency of BRG1protein,and 8.20%(5/61)of the patients were CK7-negative,and 85.11%(80/94)of the patients were CK5/6-negative,and 77.36%(82/106)of the patients were TTF-1-negative,and 80.19%(85/106)of the patients were P40-negative,and 66.67%(16/24)of the patients were CD34-negative,and 56.52%(13/23)of the patients were SALL4-negative.The 2-year survival of the patients with non-SMARCA4-deficient NSCLC was better than that of the patients with SMARCA4-deficient NSCLC(log-rank test:χ2=126.837,P＜0.001).Male gender,increase of age,having smoking history,and longer tumor diameter were independent risk factors for shortening the survival time of the SMARCA4-deficient NSCLC patients.Conclusion SMARCA4-deficient NSCLC is a type of tumor that differs from non-SMARCA4-deficient NSCLC in that it has a poorer prognosis and a higher tumor aggressiveness.