Abstract 934P
Background
We investigated the clinicopathological and genomic characteristics of young patients with the age from 14 to 40 years old with non-small cell lung cancer (NSCLC), and provided new clues and evidence for the clinical diagnosis and treatment of young patients with lung cancers.
Methods
We retrospectively analyzed young patients with NSCLC with the age from 14 to 40 who underwent radical lung cancer surgery in the Department of Thoracic Surgery of Second Xiangya Hospital of Central South University from 2017 to 2020. Meanwhile, NSCLC patients over 55 years old were enrolled as the control group. The clinical and pathological data were collected and analyzed retrospectively. Targeted-sequencing was performed to investigate the gene mutation status. Clinical, pathological and genomic features of the patients between two groups were compared.
Results
283 NSCLC patients with the age from 14 to 40 years old were identified during the study period. 161 patients over 55 years old with NSCLC were enrolled as the control group. There were significant differences in clinicopathological features between the two groups (Table). Tumors from 70 young patients and 78 elder patients were collected for NGS. The mutation rate of EGFR and ERBB2 were significantly higher in young patients, and KRAS, CDKN2A and NAF were more in elder patients. Table: 934P
Clinicopathological features and NGS results of NSCLC patients in two groups [cases (%)]
| Clinicopathological features | ≤40 years old (n=283) | ≥55 years old (n=161) | p value |
| Gender | ＜0.01 | ||
| male | 89 (31.45) | 92 (57.14) | |
| female | 194 (68.55) | 69 (42.86) | |
| Smoking history | ＜0.01 | ||
| Yes | 13 (4.59) | 51 (31.68) | |
| No | 279 (95.41) | 110 (68.32) | |
| Histological type | ＜0.01 | ||
| IAC | 146 (51.59) | 125 (77.64) | |
| MIA | 111 (39.22) | 2 (1.24) | |
| AIS | 24 (8.48) | 4 (2.48) | |
| squamous cell | 1 (0.35) | 30 (18.63) | |
| other | 1 (0.35) | 0 (0.00) | |
| CT | ＜0.01 | ||
| GGO | 247 (87.28) | 52 (32.29) | |
| solid | 36 (12.72) | 109 (67.70) | |
| Primary focus | ＜0.01 | ||
| single primary | 193 (68.20) | 140 (86.96) | |
| multiple primary | 90 (31.80) | 21 (13.04) | |
| TNM stageing | ＜0.01 | ||
| I-II | 262 (92.58) | 133 (82.61) | |
| III-IV | 21 (7.42) | 28 (17.39) |
Conclusions
The incidence of young patients with NSCLC with the age from 14 to 40 is surprisingly rising. Asymptotically, most of them were found by CT screening. Young NSCLC patients had unique clinical and genomic characteristics compared to elder patients. Females and non-smokers were more commonly seen. Most of the CT images showed single or multiple GGO lesions, and the proportion of multiple primary lesions was higher. The main pathological type was lung adenocarcinoma. EGFR and ERBB2 were the most commonly mutated genes in young patients. Young patients with NSCLC can benefit from surgical treatment for a comparatively favorable prognosis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
C. Chen.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.