Tseng C.-H.Chen K.-C.Hsu K.-H.Tseng J.-S.CHAO-CHI HOHsia T.-C.KANG-YI SUWu M.-F.Chiu K.-L.Liu C.-M.Wu T.-C.Chen H.-J.Chen H.-Y.Chang C.-S.Hsu C.-P.Hsia J.-Y.Chuang C.-Y.Lin C.-H.Chen J.J.W.KUAN-YU CHENWEI-YU LIAOJIN-YUAN SHIHSUNG-LIANG YUCHONG-JEN YUPAN-CHYR YANGYang T.-Y.Chang G.-C.2020-06-172020-06-1720150143-3334https://scholars.lib.ntu.edu.tw/handle/123456789/502849The objective of this study was to investigate the associations among lung cancer location, and epidermal growth factor receptor (EGFR) mutation status. Treatment-naive, pathologically confirmed lung adenocarcinomas with tumor specimens available for genetic analysis were included from 2011 through 2014. Overall, 1771 patients with lung adenocarcinoma were included for analysis, after excluding those with carcinoma not otherwise specified, or synchronous multiple primary lung cancers. The median age was 64 years, and the female:male and never smoker:ever smoker ratios were 930:855 (52:48%) and 1167:604 (65:35%), respectively. The EGFR mutation rate was 56%. Among patients, 1093 (62%) had primary tumors in the upper lobes. Compared with the characteristics of the EGFR wild-type, tumors with EGFR activating mutations were more common in women (P < 0.001), never smokers (P < 0.001), and in the upper lobes (P = 0.004). Among EGFR activating mutations, compared with the EGFR exon 19 deletion, L858R mutation were more common in women (P = 0.002), never smokers (P = 0.038), and the upper lobes P < 0.0005). The present study is the first to address that different pulmonary lobar locations might harbor different EGFR mutation subtypes. We demonstrated that adenocarcinomas with L858R mutation, rather than exon 19 deletion or wild-type EGFR gene, prefer to locate over the upper lungs. This phenomenon was more significant in females and never-smokers, implying the result of complex interactions between genetic susceptibility and environmental factors. Therefore, EGFR L858R mutation and exon 19 deletion may not be identical disease entity from the point of carcinogenesis. ? The Author 2015. Published by Oxford University Press. All rights reserved.[SDGs]SDG3epidermal growth factor receptor; EGFR protein, human; epidermal growth factor receptor; adult; aged; Article; cancer genetics; cancer patient; cancer surgery; cancer susceptibility; environmental factor; exon; female; gene deletion; genetic analysis; genetic association; genetic susceptibility; human; lung adenocarcinoma; lung carcinogenesis; lung lobe; lung resection; major clinical study; male; middle aged; multicenter study; mutation rate; observational study; primary tumor; priority journal; sex ratio; smoking; tumor localization; very elderly; wild type; adenocarcinoma; clinical trial; genetics; lung tumor; mass spectrometry; mutation; pathology; Adenocarcinoma; Aged; Female; Humans; Lung Neoplasms; Male; Middle Aged; Mutation; Receptor, Epidermal Growth Factor; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionizationjournal article10.1093/carcin/bgv168266457162-s2.0-84962040543