维吾尔族肺腺癌患者的EGFR基因突变分析

背景与目的 表皮生长因子受体(epidermal growth factor receptor,EGFR)是一种跨细胞膜糖蛋白,属于受体型酪氨酸激酶家族.以吉非替尼为代表的EGFR酪氨酸激酶抑制剂对于EGFR突变的肺癌患者显示出良好的治疗效果,然而EGFR的突变率在不同民族和不同种族的人群中表现出较大差异.本研究旨在分析维吾尔族中肺腺癌患者肿瘤组织的EGFR基因突变情况,同时比较维吾尔族与汉族肺腺癌患者肿瘤组织EGFR基因突变率的差异性.方法 收集临床肺腺癌患者石蜡包埋组织标本138例,包括68例维吾尔族和70例汉族肺腺癌的样本,采用ARMS(amplification refractory mutation system,ARMS)PCR扩增方法检测EGFR基因外显子18、19、20及21的突变,x2分析对比维吾尔族和汉族肺腺癌EGFR基因突变差异.结果 138例肺腺癌患者中有43例EGFR基因突变,总突变率为31.2％,其中维吾尔族突变11例,突变率为16.2％,汉族突变32例,突变率为45.7％,维吾尔族肺腺癌EGFR突变率与汉族肺腺癌EGFR突变率比较有明显差异(P＜0.001),突变以外显子19-del和L858R为主要突变点.结论 维吾尔族中肺腺癌EGFR基因突变率为16.2％,汉族中EGFR基因突变率为45.7％,维吾尔族肺腺癌EGFR突变率明显低于我国汉族EGFR基因突变.     

新疆维吾尔族与汉族非小细胞肺癌EGFR突变的差异

目的:探讨新疆地区汉族及维吾尔族非小细胞肺癌(NSCLC)患者EGFR突变发生率及差异.方法:采用ARMS法对54例汉族及50例维吾尔族非小细胞肺癌组织进行EGFR突变检测,并统计两组中EGFR突变民族差异性及相关因素差异.结果:维吾尔族非小细胞肺癌组中EGFR突变率为22.0％,汉族非小细胞肺癌组中EGFR突变率为40.7％,差异有统计学意义(P＜0.05).在EGFR突变中,均以19外显子缺失、21外显子L858R突变为主,且两者在两个民族所占比率比较无统计学差异.其他相关因素比较,如病理类型、吸烟情况与性别,两组均以腺癌、不吸烟、男性患者为主,无统计学差异(P＞0.05).结论:EGFR突变率在两个民族中存在差异,其余外显子突变情况及相关因素均无差异.     

鄂尔多斯地区晚期肺腺癌患者EGFR敏感基因突变状态与一般临床特征的关系

目的:分析鄂尔多斯市中心医院晚期肺腺癌患者表皮生长因子受体(epidermal growth factor receptor,EGFR)突变状态与一般临床特征的关系。方法:分析自2012年6月开始收治的Ⅲb-Ⅳ期肺腺癌患者接受EGFR 19、21外显子突变情况与患者一般临床特征、转移部位、治疗情况的关系。结果:选取123例晚期肺腺癌患者纳入分析,46.34%（57/123）的晚期肺腺癌患者接受了EGFR 19、21外显子检测, EGFR基因突变率为49.12%（28/57）,其中19外显子突变率为39.29%（11/28）,21外显子突变率为46.43%（13/28）,19、21外显子同时突变率为14.29%（4/28）。EGFR基因突变状态在患者性别、年龄、吸烟状态、分期、体力评分和转移部位间比较未见显著性差异,19或21外显子突变在患者性别、年龄、吸烟状态、分期、体力评分和转移部位间比较未见显著性差异,根据EGFR基因突变状态选择一线治疗模有统计学意义（P＜0.05）。结论:鄂尔多斯地区晚期肺腺癌接受EGFR敏感基因检测率为46.34%,突变率为49.12%,突变状态在一般临床特征和转移部位间未见显著性差异,根据EGFR基因突变状态患者选择一线治疗方式差异有显著意义。     

辽宁沈阳地区非小细胞肺癌EGFR基因突变分析

目的:探讨辽宁沈阳地区非小细胞肺癌（NSCLC）患者表皮生长因子受体（EGFR）基因突变情况及其与临床病理特征的关系。方法:采用扩增耐突变系统（Amplification Refractory Mutation System,ARMS）检测辽宁沈阳地区471例NSCLC患者EGFR基因第18,19,20及21外显子突变情况。结果:471例NSCLC患者共检出EGFR突变253例（53.7%）,其中19缺失和L858R突变占总突变数的42.3%,51.8%。女性患者突变率67.9%明显高于男性（37.4%）,两者之间差异有统计学意义（P=0.000）。腺癌患者突变率57.2%明显高于非腺癌患者（18.6%）,差异有统计学意义（P=0.000）。结论:辽宁沈阳地区NSCLC患者EGFR突变多见于女性,腺癌患者,突变类型以19缺失和21外显子的L858R突变为主。     

晚期肺腺癌EGFR基因突变状态检测及分析

目的分析晚期肺腺癌表皮生长因子受体（epidermal growth factor receptor,EGFR）基因突变率及其与临床特征的相关性。方法收集2010-09-07-2011-07-21首都医科大学附属北京胸科医院收治的晚期初治肺腺癌患者102例,有可供检测的肿瘤组织标本。利用扩增受阻突变系统（amplification refractory mutation system,ARMS）进行EGFR基因突变检测,统计分析EGFR基因突变状态和临床特征的相关性。结果 102例晚期肺腺癌组织中,共检测到EGFR基因突变55例（53.9%）,其中18外显子突变1例（1.0%）,19外显子突变25例（24.5%）,20外显子突变2例（2.0%）,21外显子突变26例（25.5%）,同时存在19和20外显子突变1例（1.0%）。Ⅳ期患者EGFR基因突变率为57.6%（53/92）,高于ⅢB期患者20.0%（1/10）,差异有统计学意义,P=0.041;女性患者EGFR基因突变率56.9%（33/58）高于男性患者的50.0%（22/44）,不吸烟患者EGFR基因突变率58.1%（36/62）高于吸烟患者的36.0%（9/25）,〈65岁患者EGFR基因突变率56.8%（42/74）高于≥65岁患者的46.4%（13/28）,但差异均无统计学意义,P〉0.05。不同取材部位及取材方法之间EGFR基因突变率差异无统计学意义,P〉0.05。结论晚期肺腺癌EGFR基因突变率以Ⅳ期、女性和不吸烟患者较高,但性别及吸烟状态之间的差异无统计学意义。不同的肿瘤活检部位及活检方法之间EGFR基因突变率并无差异。     

绵阳北川羌族肺腺癌患者EGFR基因突变特点的研究

目的：研究绵阳北川羌族肺腺癌患者EGFR突变的特点。方法：采用ARMS法对120例羌族肺腺癌组织进行EGFR突变检测,并分析EGFR突变与临床特征的关系。结果：120例肺腺癌患者中,57例携带EGFR突变,突变率47.5%,以L858R突变和19号外显子缺失为主,分别占52.6%（30例）和42.1%（24例）。在120例患者中,男、女突变率分别为60.7% 、35.9%,差异有统计学意义（P =0. 016）,而吸烟、不吸烟患者突变率分别为31.0%、56.4%,差异亦有统计学意义 (P =0. 012）。以患者年龄、肿瘤大小、淋巴结有无转移、肿瘤分化程度、分期对患者分组后分析发现,EGFR突变率的差异均无统计学意义（P﹥0. 05）。结论：绵阳羌族肺腺癌的EGFR突变率较高,以L858R突变和19号外显子缺失为主,EGFR突变率与性别、吸烟状况有关,而与患者年龄、肿瘤大小、淋巴结有无转移、肿瘤分化程度、分期均无明显相关性。     

非小细胞肺癌EGFR突变及临床病理特征分析

[目的]探讨非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)突变状态及其与临床病理特征的关系.[方法]收集符合入组条件的NSCLC患者300例,应用RT-PCR方法检测EGFR突变,采集临床常见的19,21外显子突变位点(delE746-A750、delL747-P753insS、L858R、L861Q)信息,分析EGFR突变状态与临床病理特征的关系.[结果]300例NSCLC患者中,EGFR突变72例,突变率24％;其中男、女性突变率分别为13.06％和45.54％(P＜0.01);吸烟与非吸烟者突变率分别为10.69％和34.31％(P＜0.01);腺癌与非腺癌突变率分别为30.72％和15.67％(P=0.02).[结论]EGFR突变是NSCLC特殊类型,与女性、非吸烟、腺癌人群密切相关.     

扩增耐突变系统对非小细胞肺癌表皮生长因子受体基因突变的检测

目的:探讨扩增耐突变系统检测非小细胞肺癌(NSCLC)患者肿瘤组织EGFR基因突变的应用价值.方法:选取70例NSCLC患者的病理切片,提取基因组DNA,分别使用EGFR外显子19和21突变检测试剂盒检测EGFR外显子19和21的突变情况,并结合临床资料进行分析.结果:70例肺癌组织中检出EGFR基因突变29例,基因突变检出率为41.4％,其中外显子19突变20例(69.0％),外显子21突变9例(31.0％);腺癌基因突变23例(79.3％),检出率为51.1％;鳞癌基因突变6例(20.7％),检出率为24.0％;肺泡癌基因突变4例(13.8％),检出率为66.7％.女性、不吸烟和肺腺癌患者的EGFR 2个外显子基因突变率均较高,P＜0.01.结论:NSCLC患者EGFR基因突变主要表现为外显子19和21的突变,女性、肺腺癌和不吸烟的患者多见.     

湖北十堰地区非小细胞肺癌患者表皮生长因子受体基因突变情况分析

目的探讨湖北十堰地区非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)基因突变情况及其与患者临床病理特征的关系。方法回顾性分析2017年11月至2020年1月就诊于湖北医药学院附属国药东风总医院的173例NSCLC患者资料。通过突变扩增阻滞系统(ARMS)-TaqMan探针法检测NSCLC组织中EGFR基因突变情况, 同时收集患者的临床病理资料, 分析EGFR基因突变状态与患者临床病理特征之间的关系。结果 173例样本中76例发生EGFR基因突变, 突变率为44.5%。其中第18号外显子突变率为6.6%(5/76), 均为G719X突变;第19号外显子突变率为46.1%(35/76), 均为Del突变;第20号外显子突变率为1.3%(1/76), 为EGFR基因20ins突变;第21号外显子突变率为44.7%(34/76), 其中33例为EGFR基因L858R突变, 1例为EGFR基因L861Q突变;1例为第19号外显子Del合并第20号外显子T790M双重突变。不同性别、吸烟史、病理分型的患者EGFR突变率比较差异均有统计学意义(均P<0.05), 女性患者高于男性患者...     

754例Ⅰ期-Ⅲa期可手术切除非小细胞肺癌患者EGFR和KRAS基因突变状态及其临床意义

背景与目的 表皮生长因子受体(epidermal growth factor receptor,EGFR)和KRAS基因是非小细胞肺癌(non-small cell lung cancer,NSCLC)重要的分子靶点,但目前研究主要集中在晚期NSCLC组织和血浆标本的EGFR检测,早期NSCLC组织样本中EGFR和KRAS突变特征尚不清楚.本研究将探讨Ⅰ期-Ⅲa期NSCLC EGFR和KRAS基因突变与相关临床病理特征的关系.方法 采用突变扩增系统(amplification refractory mutation system,ARMS)PCR方法检测北京协和医院病理科提供的754例Ⅰ期-Ⅲa期NSCLC组织样本的EGFR和KRAS基因突变状况,分析基因突变率及其与临床病理特征的关系.结果 EGFR和KRAS基因热点突变的突变率分别为34.5％和13.1％,其中有3例样本具有EGFR和KRAS基因的双突变.EGFR基因在女性中的突变率高于男性(39.5％vs 29.4％,P=0.076),在腺癌中的突变率(38.7％)高于鳞癌、腺鳞癌、大细胞癌(P＜0.01),但仍明显低于其他研究报道的亚裔晚期腺癌突变率(-50％).KRAS基因突变在男性中的突变率高于女性(16.6％vs 9％,P=0.048),且在腺癌中的突变率也高于其他类型,但差异不显著(P=0.268).与KRAS基因突变阳性组相比,EGFR基因突变阳性组在年龄分布上有年轻化的趋势(P=0.031,5),在性别分布上有显著性差异(P＜0.01).结论 Ⅰ期-Ⅲa期NSCLC EGFR基因突变率较晚期患者低,且EGFR和KRAS基因双突变的发生率为0.9％.     

Differences in Epidermal Growth Factor Receptor Gene Mutations and Relationship with Clinicopathological Features in NSCLC Between Uygur and Han Ethnic Groups

Objective: To investigate differences in mutations of epidermal growth factor receptor (EGFR) gene andrelationships with clinicopathological features in patients with non-small cell lung cancer (NSCLC) betweenUygur and Han ethnic groups. Methods: The Scorpions amplification refractory mutation system (ScorpionsARMS) was used to measure mutations in exons 18, 19, 20 and 21 of the EGFR gene in paraffin-embedded tumortissue from NSCLC cases, and statistical analysis was performed to investigate links with clinicopathologicalfeatures in different histological types of NSCLC. Results: Results from ARMS testing showed EGFR mutationsin tumor tissues from six (6) of 50 NSCLC patients of Uygur ethnic group, with a positive rate of 12.0%; four ofthem (4) had exon 19 deletion in EGFR, and two (2) had L858R point mutation in exon 21 of EGFR. Statisticallysignificant difference was noted in EGFR genetic mutation between adenocarcinoma and non-adenocarcinoma(P < 0.05), but no differences with gender, age group, smoking status, or stage (P > 0.05). EGFR mutations weredetected in tumor tissues from 27 of 49 NSCLC patients of Han ethnic group , with a positive rate of 55.1%;19 of them had exon 19 deletions, seven (7) had L858R point mutations in exon 21 of EGFR and one (1) hadmutations in both exon 18 G719X and exon 20 T790M of EGFR. Statistically significant differences were notedin EGFR genetic mutations between genders and between adenocarcinoma and non-adenocarcinoma (P<0.05),but not with age group, smoking status, or stage (P > 0.05). Conclusion: Statistically significant differences werenoted in the positive rates of EGFR genetic mutations in NSCLC patients between Uygur and Han ethnic groups,with lower positive rates for the Uygur cases.     

558例维吾尔族肺癌患者的临床病理特征及预后分析

目的 分析新疆本地维吾尔族肺癌患者的临床病理特征,了解该民族肺癌的分布特点及差异。方法 收集新疆医科大学附属肿瘤医院2005年1月1日至2014年12月31日就诊的558例维吾尔族肺癌患者,对患者的临床分期、病理类型、驱动基因等临床资料进行对比分析及随访。结果 男女比例1.37:1,女性和城市维吾尔族肿瘤患者中腺癌最多,而男性、有吸烟史和乡镇患者中鳞癌和小细胞肺癌居多;小细胞肺癌患者3年生存率最低,腺癌最高;21.8%（65/298）患者存在EGFR基因突变,多见于不吸烟、腺癌、女性患者;6.9%（11/159）患者存在EML4-AL基因融合,多表达于腺癌、不吸烟或既往有吸烟史,同时无EGFR突变患者;Ⅳ期EGFR基因突变患者与EGFR野生型患者总生存期（OS）差异无统计学意义（P=0.597）。Ⅳ期EML4-ALK基因融合患者与EML4-ALK基因未融合患者总生存期差异无统计学意义（P=0.941）。结论 维吾尔族肺癌患者在临床特征、病理类型、流行病学分布及驱动基因方面有其特点。病理类型和分期是影响维吾尔族NSCLC患者预后的独立因素。     

广西壮族非小细胞肺癌患者EGFR基因突变的研究

目的研究广西壮族非小细胞肺癌患者表皮生长因子受体（EGFR）基因突变的情况。方法收集163例广西壮族非小细胞肺癌（NSCLC）组织,采用ARMS（amplificationrefractorymutationsystem,ARMS）法PCR扩增检测EGFR基因外显子18、19、20及21的突变,进一步分析其突变与临床特征的关系,并与文献报道国内8个省、市的数据进行比较。结果163例NSCLC中共检出73例EGFR基因突变,EGFR突变阳性率为44．8％,显著高于文献报道国内8个省市的总体水平（30．0％）（P〈0．05）。其中,外显子19和21突变各占突变总数38．4％。腺癌和腺鳞癌突变发生率占突变总数的80．8％,女性EGFR基因突变率（57．7％）显著高于男性（38．7％）（P〈0．05）。结论广西壮族NSCLC患者EGFR基因突变率显著高于中国8个省、市的总体水平,其中以外显子19和21突变为多见。女性、腺癌和腺鳞癌患者是选用EGFR酪氨酸激酶抑制剂的优势人群。     

EGFR基因突变与非小细胞肺癌临床病理特征的关系

目的 研究临床病理特征及相关实验室检测指标与非小细胞肺癌患者外科手术治疗预后的关系.方法手术切除的非小细胞肺癌患者标本一共190例,采用实时荧光PCR法,检测EGFR 基因第 18、19、20 和 21 号外显子的突变情况.分析EGFR基因突变与其临床病理关系、EGFR基因突变丰度和临床特征的关系.结果 EGFR基因突变的影响因素包括:性别、吸烟史、病理分型,高危因素包括:女性、吸烟者、腺癌.190例 NSCLC 患者肿瘤组织中,成功检测出90例存在 EGFR 基因突变,EGFR 突变丰度与性别(P=0.962)、吸烟史(P=0.809)无相关性;EGFR突变丰度与病理分型相关.和非腺癌对比,腺癌患者EGFR基因突变丰度明显更高,(x2=14.110,P=0.000).术前腺癌血清VEGF水平明显低于非腺癌组,P＜0.05;术后腺癌血清CD44v6明显高于非腺癌患者,P＜0.05;术后Ⅲ～Ⅳ期组血清VEGF、CD44v6水平明显高于Ⅰ～Ⅱ期患者,P＜0.05.结论 非小细胞肺癌EGFR基因突变的高危因素为吸烟者、女性、腺癌,与年龄、性别、肿瘤分期、吸烟史无明显相关性.     

Efficacy of gefitinib for non-adenocarcinoma non-small-cell lung cancer patients harboring epidermal growth factor receptor mutations: a pooled analysis of published reports

The efficacy of gefitinib for patients with non-adenocarcinoma non-small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations is unclear, because only a small percentage of patients enrolled in the clinical trials to evaluate the efficacy of gefitinib for tumors harboring EGFR mutation were non-adenocarcinoma NSCLC. A pooled analysis was conducted to clarify the efficacy of gefitinib for non-adenocarcinoma NSCLC patients harboring EGFR mutations. A systematic search of the PUBMED databases was conducted to identify all clinical reports that contained advanced non-adenocarcinoma NSCLC patients harboring EGFR mutations and treated with gefitinib. The selected patients were advanced non-adenocarcinoma NSCLC patients harboring EGFR mutations who were treated with gefitinib and described in reports containing the data of the histology, status of EGFR mutations and response to gefitinib. This study selected 33 patients from 15 reports. Twenty-seven and three of the 33 patients were squamous cell carcinoma and adenosquamous cell carcinoma, respectively. One patient each had large-cell carcinoma, pleomorphic carcinoma and spindle cell carcinoma. Twenty-one patients (64%) had sensitive EGFR mutations. The response rate (RR), disease control rate (DCR) and median progression-free survival (mPFS) was 27%, 67-70% and 3.0 months, respectively. These factors were statistically significantly inferior in the non-adenocarcinoma NSCLC patients harboring EGFR mutations to adenocarcinoma patients harboring EGFR mutations selected from the same published reports (RR: 27%vs 66%, P = 0.000028; DCR: 67-70%vs 92-93%, P = 0.000014; mPFS: 3.0 vs 9.4 months, P = 0.0001, respectively). Gefitinib is less effective in non-adenocarcinoma NSCLC harboring EGFR mutations than adenocarcinoma harboring EGFR mutations.     

Mutation in the tyrosine kinase domain of epidermal growth factor receptor is a predictive and prognostic factor for gefitinib treatment in patients with non-small cell lung cancer.

PURPOSE: Mutations in epidermal growth factor receptor (EGFR) can be used to predict the tumor response of patients receiving gefitinib for non-small cell lung cancer (NSCLC). We investigated the association between mutations in EGFR tyrosine kinase domain and tumor response and survival in gefitinib-treated NSCLC patients. EXPERIMENTAL DESIGN: EGFR mutations in exons 18 to 21 were analyzed by DNA sequencing of paraffin-embedded tumor tissues from gefitinib-treated NSCLC patients. The results were correlated with clinical variables. RESULTS: EGFR mutations were found in 61.1% (33 of 54) of cases; response rate and disease control rate were 56.8% and 68.5%, respectively. There was no significant difference in mutation rates between adenocarcinoma (29 of 43) and nonadenocarcinoma (4 of 11; P = 0.085). However, all four nonadenocarcinomas with EGFR mutations had no response to gefitinib. Presence of EGFR mutations was the only independent predictor for disease control (P = 0.003) and tumor response (P = 0.017) in multivariate analysis; positive predictive values were 87.9% and 70.8% and negative predictive values were 61.9% and 69.2%, respectively. In comparison with patients whose tumor was negative for EGFR mutations, patients with EGFR mutations had better progression-free survival (median, 7.6 versus 1.7 months; P = 0.011) and overall survival (median, 14.7 versus 4.7 months; P = 0.046). CONCLUSIONS: Mutations in EGFR tyrosine kinase correlate with treatment response and survival in gefitinib-treated NSCLC patients and can be used as a predictive and prognostic factor. Thus, analysis of EGFR tyrosine kinase mutations in lung adenocarcinoma is of clinical significance, as it can permit the customization of treatment with EGFR tyrosine kinase inhibitors.     

Epidermal growth factor receptor mutations and gene amplification in non-small-cell lung cancer: molecular analysis of the IDEAL/INTACT gefitinib trials.

PURPOSE: Most cases of non-small-cell lung cancer (NSCLC) with dramatic responses to gefitinib have specific activating mutations in the epidermal growth factor receptor (EGFR), but the predictive value of these mutations has not been defined in large clinical trials. The goal of this study was to determine the contribution of molecular alterations in EGFR to response and survival within the phase II (IDEAL) and phase III (INTACT) trials of gefitinib. PATIENTS AND METHODS: We analyzed the frequency of EGFR mutations in lung cancer specimens from both the IDEAL and INTACT trials and compared it with EGFR gene amplification, another genetic abnormality in NSCLC. RESULTS: EGFR mutations correlated with previously identified clinical features of gefitinib response, including adenocarcinoma histology, absence of smoking history, female sex, and Asian ethnicity. No such association was seen in patients whose tumors had EGFR amplification, suggesting that these molecular markers identify different biologic subsets of NSCLC. In the IDEAL trials, responses to gefitinib were seen in six of 13 tumors (46%) with an EGFR mutation, two of seven tumors (29%) with amplification, and five of 56 tumors (9%) with neither mutation nor amplification (P = .001 for either EGFR mutation or amplification v neither abnormality). Analysis of the INTACT trials did not show a statistically significant difference in response to gefitinib plus chemotherapy according to EGFR genotype. CONCLUSION: EGFR mutations and, to a lesser extent, amplification appear to identify distinct subsets of NSCLC with an increased response to gefitinib. The combination of gefitinib with chemotherapy does not improve survival in patients with these molecular markers.     

18F-FDG PET/CT在预测非小细胞肺癌EGFR突变中的价值

目的:探讨18F脱氧葡萄糖（18F-fluorodeoxyglucose,18F-FDG）正电子发射计算机断层显像(PET/CT)最大标准摄取值（maximum standardized uptake value,SUVmax）及代谢体积（metabolic tumor volume,MTV）在预测非小细胞肺癌（non-small cell lung cancer,NSCLC）表皮生长因子受体（epidermal growth factor receptor,EGFR）突变中的价值。方法:回顾性分析141例经病理证实的NSCLC患者的临床资料,所有患者治疗前均行18F-FDG PET/CT 检查及EGFR突变检测。分析临床病理资料和PET/CT代谢参数SUVmax、MTV与EGFR突变状态的相关性。采用受试者工作特征（receiver operating characteristic,ROC）曲线获得SUVmax、MTV预测EGFR突变的最佳界值点。采用Logistic回归模型对预测EGFR突变状态的变量进行多因素分析。结果:141例入组患者中,EGFR突变型有74例（52.5%）。EGFR突变患者的MTV值明显低于野生型患者（P=0.033）,而EGFR突变患者的SUVmax与野生型患者的SUVmax间无统计学差异（P>0.05）。ROC曲线分析显示,SUVmax及MTV预测EGFR突变的最佳截断值分别是8.56,24.0 cm3,AUC分别是0.522,0.604。单因素分析结果显示,不吸烟者(P=0.001)、女性(P=0.003)、腺癌(P=0.022)及MTV＜24.0 cm3（P=0.003）的患者更易出现EGFR突变。Logistic 多因素分析显示,吸烟及MTV是预测EGFR突变的独立影响因子（P<0.05）。结论:MTV是预测NSCLC EGFR突变的独立影响因素,在预测EGFR突变中具有一定的参考价值。