晚期NSCLC患者外周血中EGFR突变检测预测靶向治疗的疗效观察  

Observation of prediction of the EGFR mutation in peripheral blood on molecular targeted therapy efficacy in advanced non-small cell lung cancer

作　　者：孙德弢 杜开齐[1] 朱有才[1] 

机构地区：[1]武警浙江省总队医院胸心外科,浙江嘉兴314000

出　　处：《中国医药导报》2012年第27期56-57,共2页China Medical Herald

基　　金：浙江省嘉兴市科学技术局科技研究计划(项目名称:HRM技术对NSCLC血清表皮生长因子受体基因突变的检测及意义;项目编号:2010AY1059)

摘　　要：目的探讨检测外周血EGFR突变与晚期NSCLC一线口服吉非替尼疗效之间的关系。方法 64例晚期NSCLC患者,用HRM(高分辨溶解曲线)技术检测外周血EGFR突变,对检测出存在EGFR突变的患者(A组)口服吉非替尼治疗,对检测不存在EGFR突变的患者(B组)给予化疗。结果 24例(37.5%)可检测出外周血EGFR突变,A组患者靶向治疗后有效率(RR)为68.4%,疾病控制率(DCR)为73.7%,中位无进展生存期(PFS)为12.0个月;B组患者化疗后RR为37.5%,DCR为43.8%,中位PFS为7.3个月。A组与B组RR、DCR比较差异具有统计学意义(χ2=4.561,P=0.033;χ2=4.314,P=0.038)。Kaplan-Meier生存曲线表明,A组生存率高于B组(χ2=7.406,P=0.006)。结论晚期NSCLC患者可通过外周血检测出EGFR突变,对一线靶向治疗具有一定的指导意义。Objective To study Gefitinib as the first-line therapeutic efficacy by detecting the EGFR mutations in peripheral blood of advanced NSCLC patients.Methods EGFR mutations in peripheral blood from 64 patients with advanced NSCLC were detected by HRM assay.Patients with EGFR mutations（group A） were treated by Gefitinib and patients without EGFR mutations（group B） were treated by chemical drugs.Results The rate of EGFR mutations in peripheral blood was 37.5%（24/64）.After treatment,the RR of group A and group B was 68.4%and 37.5%,the DCR was 73.7%and 43.8%.The differences of RR（χ2= 4.561,P = 0.033） and DCR（χ2 = 4.314,P = 0.038） between group A and group B were statistically significant.The median PFS was 12.0 months in group A and 7.3 months in group B by Kaplan-Meier survival analysis.The differences of survival rate between group A and group B（χ2=7.406,P =0.006） were statistically significant.Conclusion Detecting the mutations of EGFR in peripheral blood of patients with advanced NSCLC shows significant value in predicting the outcome of the first-line molecular targeted therapy.

关 键 词：非小细胞肺癌 表皮生长因子受体 外周血 分子靶向 治疗 

分 类 号：R687.2[医药卫生—骨科学]