Abstract: OBJECTIVE： To investigate relationships between vascular endothelial growth factor-A (VEGF-A) protein expression and epidermal growth factor receptor (EGFR) gene mutation in patients’ lung adenocarcinomas， as well as their implications as clinicopathological and prognosis indicators. METHODS： Lung adenocarcinoma tissues from 72 patients were evaluated for EGFR gene mutation VEGF-A protein in the middle-late EGFR mutation type (using immunohistochemical method). Patients were followed up to determine disease progression-free survival. The Chi-square test inspection，Kaplan-Meier survival analysis，single factor and multi-factors Cox regression analysis were used to evaluate the collected data. RESULTS：Among the 72 cases of type EGFR mutations，high expression of VEGF-A rate was 70.83% (51/72)，mainly in the cytoplasm of tumor cells. The difference in the high expression rate of VEGF-A protein expression was not statistically significant between patients with EGFR gene exon 19 deletion and other rare mutation types (P>0.05)， but statistically significant among patients with different clinical stages and lymph node metastasis status (P<0.05) There was no significant correlation with age，sex，and smoking history (P>0.05). Spearman rank correlation analysis showed that there was a significant negative correlation between progression-free survival (PFS) and VEGF-A protein expression in patients with EGFR-mutation (r=-0.513，P=0.009). The results of Kaplan-Meier survival analysis showed that the PFS of patients with high expression VEGF-A were significantly shorter than that of patients with low VEGF-A expression. The results of univariate analysis showed that lymph node metastasis， clinical stage and VEGF-A expression level were the factors affecting the prognosis of patients (HRs were 4.778，11.456，5.676，respectively). Multivariate COX regression analysis showed that clinical stage and VEGF expression (HRs were 2.054，4.949，respectively) were independent risk factors affecting survival and prognosis of patients. CONCLUSION： Relationships between VEGF-A in our patients with high expression of EGFR mutation and lymph node metastasis and clinical stages were statistically significant. VEGF-A expression and EGFR mutations and negative correlation PFS may be useful as an index of judging the prognosis of patients with lung cancer.

Key words: lung adenocarcinoma, epidermal growth factor receptor, vascular endothelial growth factor-A, prognosis judgment