Abstract：Objective: To explore the establishment and preliminary evaluation of a model for predicting epidermal growth factor receptor (EGFR) mutation in lung adenocarcinoma by thyroid transcription factor-1 (TTF-1), a tumor marker. Methods: 120 patients with primary lung adenocarcinoma admitted to our hospital from June 2018 to May 2019 were selected as subjects. According to the results of EGFR genotype detection, they were divided into wild (non-mutation) group of EGFR gene (72 cases) and mutation group of EGFR gene (48 cases). TTF-1 expression was detected by En Vision immunohistochemistry, mutations in exons 18, 19, 20 and 21 of EGFR gene were detected by amplification-blocked mutation system, and multivariate logistic regression was used to analyze the related factors affecting EGFR gene mutation in patients with lung adenocarcinoma. Results: The positive rate of TTF-1 expression in lung adenocarcinoma patients with EGFR gene mutation was significantly higher than that in wild EGFR gene group (P<0.05). The mutation of EGFR gene was not related to age, performance status (PS) score and location of lung adenocarcinoma (P>0.05), but related to sex, smoking history and TNM stage of lung adenocarcinoma (P<0.05). Multivariate logistic regression analysis showed that TNM stage and TTF-1 expression were independent risk factors for EGFR gene mutation in lung adenocarcinoma patients (P<0.05), while gender, smoking history and EGFR gene mutation in lung adenocarcinoma patients had no independent correlation (P>0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TTF-1 expression alone and in combination with clinicopathological parameters in predicting EGFR gene mutation in lung adenocarcinoma patients were the combination prediction of TTF-1, sex, smoking and TNM stage, the combination prediction of TTF-1, sex and smoking, the combination prediction of TTF-1 and sex, and the separate prediction of TTF-1 expression. Conclusions: TTF-1 positive is associated with EGFR gene mutation. TTF-1 expression combined with other factors may be more helpful in predicting EGFR gene mutation in patients with lung adenocarcinoma.
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2020, Vol. 26 
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