关于表皮生长因子受体 (EGFR) 亚型在晚期肺癌患者中不同的临床表现，本研究旨在评估 EGFR 突变亚型在晚期肺癌患者中的临床、病理和预后意义以及治疗反应。一项回顾性研究纳入了346名接受 EGFR 突变检测的晚期肺癌患者。EGFR 突变通过扩增不变性突变系统-聚合酶链反应 (ARMS-PCR) 进行分析。统计分析使用 SPSS 20.0 版本进行。38% 的患者存在 EGFR 突变，其中以外显子19的缺失最为普遍。年轻患者的19缺失和20插入的发生率更高，而老年患者的L858R发生率更高。新生T790M突变的患者未能通过任何治疗方式改善其生存率。患有新生T790M突变的患者患肺、肝和多个部位的转移的风险更高，而L858R 突变的患者患脑转移的风险更高。此外，接受常规化疗后患有19缺失突变的患者未能改善其生存率，因此只有接受EGFR-TKI治疗后才表现出更好的生存。多元生存分析预测化疗是 OS 的独立预测因子。除了 EGFR 突变和突变亚型的临床病理和预后后果外，携带 TKI 敏感或无反应突变的患者显示出不同的继发疾病发展，因此应根据其情况进行不同的治疗以实现更好的生存。当前发现可能为更好的治疗策略提供基础。 ©2023年作者，独家授权给 Springer Nature B.V.

Concerning the different clinical behavior of epidermal growth factor receptor (EGFR) subtypes in advanced-stage lung cancer patients, the current study aimed to evaluate the clinical, pathological, and prognostic significance of EGFR mutation subtypes, and treatment response in patients with advanced-stage lung cancer.A retrospective study enrolled a total of 346 patients with advanced-stage lung cancer tested for EGFR mutation. EGFR mutation was analyzed by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Statistical analysis was performed using SPSS version 20.0. EGFR mutation was evident in 38% of patients with the highest prevalence of exon 19 deletions. A higher incidence of 19-deletions and 20-insertions were observed in young patients, while a higher incidence of L858R was noted in old age patients. Patients with de-novo T790M failed to improve their OS by any of the treatment modalities. Patients with de-novo T790M mutation have a higher risk of developing lung, liver, and multiple site metastases while patients with L858R mutation have a higher risk of developing brain metastasis. Additionally, patients with 19 deletion mutation did not improve their OS after receiving conventional chemotherapy hence, they demonstrate better survival only after EGFR-TKIs. Multivariate survival analysis predicted chemotherapy as an independent predictor of OS.Besides clinicopathological and prognostic consequences of EGFR mutation and mutation subtypes, patients harboring TKI sensitive, or insensitive mutations reveal different secondary disease development and hence should be treated accordingly for better survival. Current findings may provide the basis for a better treatment strategy.© 2023. The Author(s), under exclusive licence to Springer Nature B.V.