title: Histological subtype and smoking status, but not gender, are associated withepidermal growth factor receptormutations in non-small-cell lung cancer.
abstract: Mutations inepidermal growth factor receptor(EGFR) commonly occur in non-small-cell lung cancer (NSCLC) patients characterized by female gender, never-smoker status and adenocarcinoma histology. The aim of this study was to determine whether gender is a confounding factor forEGFRmutations in NSCLC. To elucidate the confounding effect, Pearson's χ2test and logistic regression models were used to correlate these characteristics withEGFRmutations in 426 NSCLC patients treated at our institutes. Of those 426 NSCLC patients, 47% were females, 57% were non-smokers and 84% had adenocarcinomas. The multivariate logistic regression analysis demonstrated that never-smoker status [odds ratio (OR)=3.49, 95% confidence interval (CI): 1.99-6.13; P<0.001)] and adenocarcinoma (OR=9.43, 95% CI 3.62-24.56; P<0.001) were associated withEGFRmutations; however, gender was not (OR=1.25, 95% CI: 0.73-2.15; P=0.416). Furthermore, gender was not associated withEGFRmutation subtypes (OR=1.19, 95% CI: 0.56-2.50; P=0.650). The frequency ofEGFRmutations among females and males was not different in non-smokers (64.8 vs. 55.8%, P=0.204) or ever-smokers (27.8 vs. 24.2%, P=0.775). Therefore, if the assessment forEGFRmutation status was limited to non-smoking females with adenocarcinoma, up to 40% of the patients harboringEGFRmutations would be precluded from the benefit ofEGFRinhibitor therapy. Our results indicated that gender is a confounding factor forEGFRmutations in NSCLC and suggested that gender may not be associated with tumorigenesis in NSCLC-harboringEGFRmutations.
authors.affiliation: Molecular Medicine Program, School of Life Sciences, National Yang-Ming University, Taipei, Taiwan, R.O.C. ; Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Shih-Hsin
authors.initials: SH
authors.lastname: Hsiao
authors.affiliation: Department of Pathology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Sey-En
authors.initials: SE
authors.lastname: Lin
authors.affiliation: Institute of Biomedical Science, Academia Sinica, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Chou
authors.affiliation: Department of Pediatrics, Department of Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C. ; Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Jinn-Li
authors.initials: JL
authors.lastname: Wang
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C. ; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Chi-Li
authors.initials: CL
authors.lastname: Chung
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Ming-Chih
authors.initials: MC
authors.lastname: Yu
authors.affiliation: Department of Pathology, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Chia-Lang
authors.initials: CL
authors.lastname: Fang
authors.affiliation: Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Hsin-Lun
authors.initials: HL
authors.lastname: Lee
authors.affiliation: School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Ling-Ling
authors.initials: LL
authors.lastname: Chiang
authors.affiliation: Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C. ; Division of Hematology and Oncology, Department of Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: H Eugene
authors.initials: HE
authors.lastname: Liu
authors.affiliation: Molecular Medicine Program, School of Life Sciences, National Yang-Ming University, Taipei, Taiwan, R.O.C. ; Institute of Biomedical Science, Academia Sinica, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Cheng-Wen
authors.initials: CW
authors.lastname: Wu
keywords: a confounding factor; epidermal growth factor receptor mutations; gender; non-small-cell lung cancer