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Mol Clin Oncol. 2014 Mar;2(2):252-258. Epub 2013 Dec 23.

Histological subtype and smoking status, but not gender, are associated with epidermal growth factor receptor mutations in non-small-cell lung cancer.

Author information

  • 1Molecular 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.
  • 2Department of Pathology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C.
  • 3Institute of Biomedical Science, Academia Sinica, Taipei Medical University, Taipei, Taiwan, R.O.C.
  • 4Department 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.
  • 5Division 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.
  • 6Division of Pulmonary Medicine, Department of Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C.
  • 7Department of Pathology, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C.
  • 8Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C.
  • 9School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C.
  • 10Graduate 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.
  • 11Molecular 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.

Abstract

Mutations in epidermal 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 for EGFR mutations in NSCLC. To elucidate the confounding effect, Pearson's χ2 test and logistic regression models were used to correlate these characteristics with EGFR mutations 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 with EGFR mutations; however, gender was not (OR=1.25, 95% CI: 0.73-2.15; P=0.416). Furthermore, gender was not associated with EGFR mutation subtypes (OR=1.19, 95% CI: 0.56-2.50; P=0.650). The frequency of EGFR mutations 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 for EGFR mutation status was limited to non-smoking females with adenocarcinoma, up to 40% of the patients harboring EGFR mutations would be precluded from the benefit of EGFR inhibitor therapy. Our results indicated that gender is a confounding factor for EGFR mutations in NSCLC and suggested that gender may not be associated with tumorigenesis in NSCLC-harboring EGFR mutations.

KEYWORDS:

a confounding factor; epidermal growth factor receptor mutations; gender; non-small-cell lung cancer

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