非小细胞肺癌患者EGFR基因突变状态影响因素的临床分析  

Clinical analysis of factors inl uencing EGFR mutation status in patients with non-small cell lung cancer

作　　者：张怡湜 何雅億[1] 李雪飞[1] 任胜祥[1] 赵超[1] 周彩存[1] 

机构地区：[1]同济大学附属上海市肺科医院肿瘤科,上海200433

出　　处：《肿瘤》2014年第2期147-152,共6页Tumor

基　　金：2013年度上海市卫生和计划生育委员会青年科研资助项目(编号:183);上海市科委“创新行动计划”基础研究重点资助项目(编号:11JC1411300)

摘　　要：目的:探讨中国人表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变状态与非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的性别、年龄、吸烟状态、是否有肿瘤家族史及组织学类型等因素的相关性。方法:2008年2月—2012年5月,共入组在上海市肺科医院确诊为NSCLC,并进行EGFR基因突变状态检测的患者538例。EGFR基因突变状态应用突变特异性扩增系统(amplii cation refractory mutation system,ARMS)检测,EGFR基因突变状态与各临床特征的相关性采用Logistic回归分析。结果:本次研究共有220名患者存在EGFR基因突变,EGFR基因突变在女性(P<0.001)、腺癌患者(P<0.001)、不吸烟者(P<0.001)及有肿瘤家族史(P=0.031)患者中的发生率高。多因素回归分析结果显示,病理类型[比值比(odds ratio,OR)=0.035)]、吸烟状态(OR=0.005)及肿瘤家族史(OR=0.027)为EGFR基因突变率的独立影响因子。结论:NSCLC患者中,病理学类型、吸烟状态及肿瘤家族史为EGFR基因突变率的独立影响因子。Objective： To investigate the associations of the mutation status of epidermal growth factor receptor （EGFR） with the factors including gender, age, smoking status, family history and histological type in patients with non-small cell lung cancer （NSCLC）. Methods： From February 2008 to May 2012, 538 consecutive NSCLC patients went through the clinical testing for EGFR mutations in Shanghai Pulmonary Hospital were included in this study. Amplification refractory mutation system （ARMS） method was used to detect EGFR mutation status. The relationships between EGFR mutation and potential related factors were evaluated by using Logistic regression model. Results： The activating mutation of EGFR was found in 220 patients. EGFR mutation was more frequently detected in females （P 〈 0.001）, patients with adenocarcinoma （P 〈 0.001）, never-smokers （P 〈 0.001） and patients with family history of cancer （P = 0.031）. Multivariate analysis revealed that pathologic type [odds ratio （OR） = 0.035）], smoking status （OR = 0.005） and family history of cancer （OR = 0.027） were independent predictive factors of EGFR mutation. Conclusion： The factors of pathologic type, smoking status and family history of cancer are independent predictive factors of EGFR mutation.

关 键 词：癌 非小细胞肺 受体 表皮生长因子 DNA突变分析 统计学 医学 

分 类 号：R734.2[医药卫生—肿瘤]