42例晚期肺腺癌患者外周血游离DNA的EGFR基因突变检测指导靶向治疗的临床观察  

Guide the Targeted Therapy by EGFR Mutations Detection of Free DNA in Peripheral Blood from 42 Patients with the Advanced Lung Aadeno-carcinoma

作　　者：陈群[1] 谢强[1] 石琴[1] 肖松[1] 李育宏[1] 林江平[1] 王成辉[1] 陈巧林[1] 黄新辉[1] 王琳[1] CHEN Qun, XIE Qiang ,SHI Qin, et al （Department of Oncology, the Affiliated Fuzhou Pulmonary Hospital of Fujian Medical University, Fuzhou 350008 , China）

机构地区：[1]福建医科大学附属福州肺科医院肿瘤内科,福建福州350008

出　　处：《医学信息》2011年第15期4972-4974,共3页Journal of Medical Information

摘　　要：目的通过对42例晚期肺腺癌患者血清循环DNA的EGFR基因突变检测，筛选EGFK突变型患者并评估靶向性药物酪氨酸激酶抑制剂（TKIs）对其的临床疗效。方法从42例肺腺癌患者血清中提取DNA，使用突变富集-液相芯片联用法检测。结果42例肺腺癌患者血清DNA中。EGFR突变率为47．6％（20／42），其中外显子19缺失和21突变分别占26．2％（11／42例），35．7％（15／42例），EGFR基因突变于女性患者55．0％。对20倒EGFR基因突变NSCLC患者进行TKIs靶向治疗，客观有效率（ORR）为60．0％，病情控制率（DcR）为85．0％；疾病进展时间（TTP）72～637天。中位TTP172．5天。另有22例EGFR野生型NSCLC患者全部服用特罗凯，RR为13．6％，DCR．为36．4％；TTP36-221天，中位TTP108天。组间ORR、DCR、中住TTP比较，差异存在统计学意义。结论部分晚期肺腺癌患者肿瘤组织难以获得，外周血中游离DNA的EGFK突变检测便成为一种选择。本研究提示以外周血中游离DNA的EGFR突变检测结果为依据选择TKIs药物治疗，对晚期肺腺癌患者具有一定指导意义。Objective screened EGFR mutation and evaluated the effects of epidermal growth factor receptor tyrosine kinase inhibitors （EGFR-TKi） by EGFR mutation detection of free DNA in peripheral blood from 42 patients with advanced lung adenoeareinoma. Method To extract the serum free DNA in peripheral from 42 patients with advanced lung adenacareinoma. To use the joint detection by the technology of mutant-enriched PCR and luminex. Result The EGFR mutation rate of free DNA in peripheral blood from the 42 patients with advanced lung adenocareinoma was 47.6 %（20/ 42）. Among the 42 patients , exon 19/21 mutation rate were 26.2% （11/42）and 35.7% （15/42）severally. The mutation rate of EGFR gene for female was 55.0% . To select targeting therapy of TKi against the advanced lung adenocareinoma for 20 patients with EGFR mutations . The objective respond rate （ORR） was 60.0% , the disease control rate （DCR） was 85.0% , time to progress （TIP） was 72-637 days , the median TIP was 172.5 days . 22 eases wild-type of NSCLC take erotinib 150mg qd . The ORR was 13.6% , the DCR was 36.4% , TTP was 36-221 days , the median TIP was 108 days . The group differences were significant at ORR, DCR and mTYP. Conclusion It is hard to acquire the tumor tissues of patient with advanced adenoeareinoma, so EGFR mutations detection of free DNA in peripheral blood had become an option. It is importance value to select targeting therapy of TKi against the advanced lung adenocaroinoma on the basis of EGFR gene mutation detection of free DNA in peripheral blood.

关 键 词：肺腺癌 血清 表皮生长因子受体(EGFR) 酪氨酸激酶抑制剂(TKIs) 个体化治疗 

分 类 号：R734.2[医药卫生—肿瘤;医药卫生—临床医学]