EGFR分子标志及其检测方法对肺癌患者EGFR-TKI疗效预测研究进展  

Predictive value of EGFR biomarker detection in lung cancer patients with EGFR-TKI therapy

作　　者：李伟 孟雪[2] 孙新东[2] 于金明[2] 

机构地区：[1]齐河县中医院肿瘤科,山东齐河251100 [2]山东省肿瘤医院放疗科,山东济南250117

出　　处：《中华肿瘤防治杂志》2013年第21期1699-1702,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然基金青年科学基金(81201827)

摘　　要：目的:总结目前表皮生长因子受体(epithelial growth factor receptor,EGFR)的检测方法,探讨其在肺癌患者靶向治疗药物酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)疗效预测中的应用。方法:应用PubMed及CNKI期刊全文数据库检索系统,以"非小细胞肺癌、表皮生长因子受体、基因突变、TKI和预后"为关键词,检索2006-2013年发表的相关文献。纳入标准:1)EGFR分子标志在肺癌中的表达;2)EGFR的检测方法;3)筛选肺癌患者TKI疗效的途径。符合要求纳入分析的文献25篇。结果:EGFR检测对患者的个体化治疗具有重要的参考价值。现有检查方式均需获得肿瘤组织标本,为有创性检查,对难以获得有效肿瘤标本的患者无法完成检测工作。对不能获取组织标本的患者中可考虑利用其外周血进行EGFR突变检测,但是由于外周血中DNA含量偏低,因此如何提取出尽可能多的DNA和提高突变检测的特异度和灵敏度需要在实验中进一步优化。此外TKI疗效的监测是一个动态的过程,PET-CT EGFR显像为无创性筛选EGFR-TKIs优势人群和动态监测疗效提供了可能。结论:目前尚缺乏对在体肿瘤组织EGFR水平进行评估的理想方法。随着分子显像和分子探针的发展,EGFR分子影像已逐步走进临床,虽然这些技术尚未常规应用,但却有从根本上改变NSCLC患者诊断、治疗和疗效监测的可能。OBJECTIVE：To review the detection methods of epidermal growth factor receptor（EGFR） sensitive mu tation and outline its usefulness in selecting population who fit to tyrosine kinase inhibitor（TKI） therapy. METHODS： The key words included non-small cell lung cancer（NSCLC）, EGFR, gene mutation,TKI and prognosis were searched from CNKI and Pubmed database between 2006 and 2013. The criteria was as follows： 1） the expression of EGFR in NSCLC; 2） the methods of detection EGFR3） the methods to select population who fit to TKI therapy. RESULTS：The biological study was relayed on tissue specimens. The biological characteristics of solid tumor were not always homogenous and me tastases could be quite different from the primary tumors. In addition, the procedures of tumor biopsy usually were inva-sive and it was not always satisfactory. Considering all these questions,it was needed to find a potential new tool for cancer patient＇s care. PET-CT might be a novol technology to detect EGFR noninvasively and individually. CONCLUSIONS： The detection of EGFR mutation has much reference value to individualized therapy. TKI for patients with mutations in the EGFR gene is effective. Screening of such drugs before treatment is a premise of individualized treatment. EGFR PET-CT may be a useful method in selecting the NSCLC patients.

关 键 词：癌 非小细胞肺 表皮生长因子受体 基因突变 酪氨酸激酶抑制剂 综述文献 

分 类 号：R734.2[医药卫生—肿瘤]