Similarly, the overall analysis of eight driver genes mutations (including EGFR, KRAS, ALK, ROS1, MET, RET, HER-2 and BRAF) demonstrated that the NSCLC coexisting COPD group exhibited a lower concordance rate of eight driver genes mutations (7.69%) compared to the NSCLC alone group (45.54%) and the NSCLC coexisting with prodromal changes in COPD group (47.37%) (Table S6). This evidence concerns the gene ALK and chronic obstructive pulmonary disease.