Objective: To investigate the efficacy of osimertinib in the treatment ofadvanced lung adenocarcinoma with sensitive mutation of EGFR gene and analysis of the factors affectingbrain metastasis. Methods: Retrospectively selected 68 cases of advanced lung adenocarcinoma patients with sensitive mutation ofEGFR gene who were admitted to the Third Hospital of Xingtai City from January 2017 to January 2019 as the research objects. According to different treatment method, they were divided into the osimertinib group(42 cases) and the gefitinib group(26 cases). The clinical efficacy, brain metastasis rate, the levels of tumor markers[cytokeratin 19 fragment (CYFRA21-1), carbohydrate antigen 125 (CA125), vascular endothelial growth factor (VEGF)]and four transmembrane protein CD151 were compared between the two groups. In addition, patients were divided into brain metastasis group and non-brain metastasis group according to whether the patients had brain metastasis during treatment. The CD151 expression levels of the two groups were compared, and the Cox model was used for multi-factor analysis of survival and prognosis. Results: The objective response rateand disease control rate in the osimertinib group were significantly higher than those in the gefitinib group (P<0.05). After treatment, the levels of tumor markers and CD151 in the osimertinib group were significantly lower than those in the gefitinib group (P<0.05). The median survival time of patients in the osimertinib group[(11.06±0.32) months] was longer than that of gefitinib[(9.09±0.21) months] (log-rank P=0.024). TNM stage, brain metastasis, and smoking were independent risk factors which affected the prognosis of advanced lung adenocarcinomapatients with sensitive mutation of EGFR gene. The rate of new brain metastasis (21.62%) in the oxitinib group was significantly lower than that in the gefitinib group (45.83%) (P<0.05), and the expression level of CD151 in the brain metastasis group was significantly higher than that in the non-brain metastasis group (P<0.05). Conclusion: Osimertinib has significant clinical efficacy in the treatment ofadvanced lung adenocarcinoma with EGFR gene-sensitive mutations. The mechanism of action may be throughCD151 regulatingthe expression of related pathwwayproteins, thereby affecting the proliferation and migration of lung cancer cells and prolonging the survival of patients. period.
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