Objective: To investigate the relationship between the status of epidermal growth factor receptor (EGFR) mutations and brain metastases in patients with lung adenocarcinoma. Methods: From August 2010 to May 2015, a total of 1 063 lung adenocarcinoma patients with identified status of EGFR mutations in Shanxi Cancer Hospital were enrolled, of which 456 patients had EGFR mutations. Multivariate Logistic regression model was used to analyze the correlation between EGFR mutation status and brain metastases in patients with lung adenocarcinoma. Results: In 125 patients with brain metastases before initial treatment, 65 patients had EGFR mutations, including 36 patients with deletion mutations in exon 19. The frequency of EGFR 19 exon mutation was 28.8% (36/125). Among 456 patients with EGFR mutations, 65(14.3%) patients were with brain metastases, in which 36(55.0%) had deletion mutations in exon 19. The multivariate analysis showed that age, Eastern Cooperative Oncology Group (ECOG) score, EGFR mutations and N staging were associated with brain metastases(P<0.05). Further subgroup multivariate analyses showed that age, ECOG score, mutation status in exon 19 and N staging were associated with brain metastases (P<0.05). Conclusions: EGFR mutation status is related to brain metastases. Mutations in EGFR exon 19 is an independent risk factor for brain metastases.
目的： 探讨表皮生长因子受体(EGFR)突变与肺腺癌患者脑转移的关系。 方法： 收集2010年8月至2015年5月山西省肿瘤医院收治的行EGFR基因突变检测的1 063例肺腺癌患者，其中456例患者EGFR突变。采用Logistic多因素回归模型分析EGFR突变与肺腺癌患者脑转移的关系。 结果： 初诊时发现脑转移的125例患者中，EGFR突变65例，其中EGFR 19外显子突变36例。125例初诊脑转移患者中，EGFR 19外显子的突变频率为28.8%(36/125)。456例EGFR突变患者中，脑转移65例(14.3%)，其中EGFR 19外显子突变36例(55.0%)。多因素分析显示，年龄、美国东部肿瘤协作组(ECOG)评分、EGFR突变状态和N分期与患者脑转移均有关(均P<0.05)。亚组多因素分析显示，年龄、ECOG评分、EGFR 19外显子状态和N分期与患者脑转移均有关(均P<0.05)。 结论： EGFR突变与脑转移有关，EGFR 19外显子突变为脑转移的独立危险因素。.
Keywords: Adenocarcinoma; Brain metastases; Lung neoplasms; Mutation; Receptor, epidermal growth factor.