The clinicopathological features and possible physiological mechanisms of only EGFR-T790M primary mutation in lung adenocarcinoma patients

Abstract

Abstract The EGFR-T790M mutation often increases the difficulty of treatment in non-small cell lung cancer patients. The only EGFR-T790M primary mutation of the lung adenocarcinoma(LUAD) is rare, there are relatively few reports on the clinicopathological characteristics and physiological mechanisms of this disease. We collected the clinical data of LUAD patients with only EGFR-T790M primary mutation to analyze the Clinicopathological features and possible physiological mechanism and provide evidences for clinical treatment. We found that the β-Catenin and Cyclin D1 were strongly positive. Only using the EGFR TKIs to treat this disease can obtain a partial response(PR) time of less than 8 months, Serum CYFRA 21 − 1 was significantly increased in the patient with Ki67 and mutant P53 positive, and the tumor cells are easy to metastasize and have a fast course of disease. The patient with negative Ki67 and mutant P53 underwent surgical resection and adjuvant chemotherapy, and the progression-free survival (PFS) time was 25 months. Our findings reveal that only EGFR-T790M primary mutation has no concern with the staging of lung cancer, it is related to the abnormal activation of Wnt signaling pathway; The combination of Ki67 and mutated P53 may be used as a prognostic indicator for this kind of patients.