title: Relationship between EGFR gene mutation and local metastasis of resectable lung adenocarcinoma.
abstract: BACKGROUND
  Resectable lung adenocarcinoma is dominated by peripheral distribution, and surgical resection is the main treatment protocol. However, high recurrence rate remains after surgery. Lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutation has strong invasion ability, but the effects of this mutation on local invasion in early lung adenocarcinoma have been rarely studied. This study aimed to assess the effects of EGFR mutation on local invasion in resectable lung adenocarcinoma.
  
  
  METHODS
  A retrospective analysis of 103 patients clinically diagnosed with peripheral lung adenocarcinoma was included. They underwent preoperative bronchoscopy, which indicated grades 2 or 3 bronchial involvement (lumen of the lobe or segment). The associations of EGFR mutation with pleural invasion, endobronchial metastasis, and lymph node metastasis were analyzed according to pathologies of pleural invasion and lymph node metastasis, as well as EGFR gene mutation detected by postoperative pathological specimens. Statistical analyses were performed by unpaired Chi-square test using the SPSS16.0 software.
  
  
  RESULTS
  In patients with EGFR mutation, pleural invasion, endobronchial metastasis, and lymph node metastasis rates were 62.5, 39.1, and 34.4%, respectively, indicating statistically significant differences (p = 0.003). Meanwhile, the pleural invasion rate in patients with wild-type EGFR was 43.6%, significantly reduced compared with patients with mutated EGFR (62.5%; p = 0.018). In addition, the endobronchial metastasis rate in patients with wild-type EGFR was 17.9%, significantly lower than in patients with EGFR mutation (39.1%; p = 0.005). However, lymph node metastasis rates were similar between EGFR mutated and wild-type patients (34.4 vs 25.6%, respectively, p > 0.05).
  
  
  CONCLUSIONS
  Early resectable lung adenocarcinoma patients with EGFR mutation showed a higher rate of local invasion compared with those harboring wild-type EGFR. This finding provides a basis for improved therapy.
  
  
  BACKGROUND
  This study was supported by Project of Medical and Health Science Technology in Shandong Province ( 2015WS0376 ).
authors.affiliation: Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China.
authors.forename: Yunqiang
authors.initials: Y
authors.lastname: Nie
authors.affiliation: Department of Blood Screening Test, Linyi People's Hospital, Linyi, 276000, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China.
authors.forename: Na
authors.initials: N
authors.lastname: Li
authors.affiliation: Department of Oncology, Linyi People's Hospital, Linyi, 276000, China.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China.
authors.forename: Cuiyun
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Pathology, Linyi People's Hospital, Linyi, 276000, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Han
authors.affiliation: Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China.
authors.forename: Yingmei
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Lv
authors.affiliation: Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China.
authors.forename: Xinyi
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Medicine, Linyi People's Hospital, Linyi, 276000, China. ghongsheng@126.com.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Liu
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000556:secondary / Q000601:surgery; D001984:Bronchial Neoplasms / Q000235:genetics* / Q000556:secondary / Q000601:surgery; D001999:Bronchoscopy; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: Bronchial grade; Bronchoscopy; EGFR; Endobronchial metastasis; Lung adenocarcinoma