Gene Mutation Rates in Lung Cancer Correlate with Different Clinical Indicators

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Lung cancer is the leading cause of death from cancer with approximately 1.8 million people dying from the disease each year. Non–small-cell lung cancer (NSCLC) accounts for 75% to 80% of all lung cancer cases and has a poor 5-year survival rate of <20%. Standard treatment guidelines for NSCLC in stage I-IIIA call for surgery with adjuvant chemotherapy; however, the effect of adjuvant chemotherapy can differ due to tumor drug resistance and other individual factors. To achieve higher treatment success, individualized treatment based on molecular biology has been proposed, as in many cases it drives accurate and effective treatment management. Epidermal growth factor receptor (EGFR), Kirsten rat sarcoma (KRAS), and phosphatidylinositol 3-kinase (PIK3CA) are gene mutations found in lung cancer, but there have been few studies that evaluate the relationship between these mutations and lung cancer.

A recent article in the World Journal of Surgical Oncology presented an analysis of EGFR, KRAS, and PIK3CA gene mutation rates and their distribution in 221 patients with lung cancer. The study enrolled 114 males and 107 females with an average age of 59.6 years. Whole blood and tissue samples were collected from the participants and analyzed to determine the mutation status and gene exon mutation rates of the EGFR, KRAS, and PIK3CA genes. Analysis of EGFR gene mutations determined the mutation rate was 2.3% for exon E18, 17.6% for exon E19, and 3.6% for exon E20. These mutations were commonly detected in participants with adenosquamous carcinoma. Patients with stage IA lung cancer and those who underwent surgical resection had a higher E18 mutation rate. E19 mutation rates were higher in patients with stage IB cancer, and E20 mutation rates were higher in patients with stage IIIB cancer. Exon E21 mutations were commonly found in adenocarcinoma, with a mutation rate of 20.4%. The E21 mutation rate was 29.91% in females and 11.4% in males. The mutation rate for E21 was significantly higher in stage IB lung cancer patients than in other stages and was higher in patients who had surgical resection than in those who had chemotherapy.

KRAS gene mutation rate analysis found that exon E2 had a higher mutation rate in whole blood and tissue samples than other exon mutations. In exon E2, the gene mutation rate was higher in patients with adenosquamous carcinoma and in patients with stage IIB lung cancer. The E3 KRAS gene mutation rate was significantly higher in patients with stage IA lung cancer and more common in patients with adenocarcinoma. In patients aged <60 years, PIK3CA gene mutations occurred in exons E9 and E20. Exon E20–positive mutations were more common in females while exon E9–positive mutations were more common in males. Exon E9–positive mutations were also more common in patients with squamous-cell carcinoma.

Gene mutation rates in lung cancer were correlated with different clinical indicators in this study.

Source

Li S, Li X. Analysis of EGFR, KRAS, and PIK3CA gene mutation rates and clinical distribution in patients with different types of lung cancer. World J Surg Oncol. 2021;19:197.

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