Meta-Analysis of The Association Between Gene Mutation and Tumor Spread Through Air Space in Lung Adenocarcinoma

Abstract Background A series of studies have shown that spread through air spaces (STAS) has a significant effect on surgical outcomes in patients with lung adenocarcinoma. Objectives: The aims of this study are to evaluate the association between gene mutation and STAS in lung adenocarcinoma for preoperative prediction of STAS in lung adenocarcinoma, eventually, which could help us choose appropriate surgical type. Methods The retrieval period was from 2015 to December 2020. The Newcastle-Ottawa quality assessment scale (NOS) was used for assessing the quality of each study. High-quality study was defined as those with ≥6 stars at the NOS. Statistical results were analyzed using the Stata16 statistical package. Results A total of 12 studies were included, including 4790 patients. The results of meta-analysis showed that: In patients with lung adenocarcinoma, the expression of EGFR, KRAS, BRAF, ALK and ROS1 were correlated with the occurrence of STAS, with RR values (95%CI) of 0.75 (0.63~0.90), 1.173 (1.00~1.37), 2.116 (1.17~3.84), 1.71 (1.53~1.90), 1.565 (1.35~1.82), respectively. Conclusion Mutations in KRAS, BRAF, ALK, and ROS1 increase the incidence of STAS in patients with lung adenocarcinoma. Mutations in EGFR decrease the incidence of STAS in patients with lung adenocarcinoma.