非小细胞肺癌EGFR突变非侵入性检测技术研究进展  

Progress in Non-invasive Detection of EGFR Mutation in Non-small Cell Lung Cancer

作　　者：袁世洋 邹叶青[2] 谢军平[1] Shiyang YUAN;Yeqing ZOU;Junping XIE(Department of Respiratory and Critical Care Medicine;Jiangxi Province Key Laboratory of Molecular Medicine,the Second Affiliated Hospital of Nanchang Universityj Nanchang 330006.China)

机构地区：[1]南昌大学第二附属医院呼吸与危重症医学科,南昌330006 [2]南昌大学第二附属医院江西省分子医学重点实验室,南昌330006

出　　处：《中国肺癌杂志》2018年第12期912-917,共6页Chinese Journal of Lung Cancer

基　　金：江西省自然科学基金项目(No.20161BAB205265)资助~~

摘　　要：在过去的十年里,癌症患者的管理模式已经逐渐转向为基于分子突变检测的个体化模式。表皮生长因子受体(epidermal growth factor receptor, EGFR)基因突变是非小细胞肺癌(non-small cell lung cancer, NSCLC)的重要驱动因素,针对EGFR的靶向治疗和传统化疗相比,显示出显著的安全性和有效性。然而,并不是所有的EGFR突变患者都可接受EGFR靶向治疗,不同的突变类型往往预示着不同的临床结局,如敏感性突变EGFR 19-Del、L858R和耐药性突变20ins。此外,如今已经开发出第三代TKI药物Osimertinib(AZD9291)和Rociletinib(CO-1686)可使因EGFR T790M突变,导致初代TKI耐药的患者进一步获益。因此,治疗前了解患者EGFR突变状态,治疗过程中持续监测耐药基因EGFR T790M突变情况,对NSCLC患者靶向药物的管理有着重要的意义。最近几年来,"液体活检"技术得到快速的发展,让我们看到采用非侵入性方法以实时监测耐药性突变成为现实的可能。在本综述中,我们回顾了NSCLC中检测EGFR突变的多种非侵入性检测技术在不同液体样本的临床应用。Over the past decade, the management model of cancer patients has gradually shifted to individual mode based on molecular mutation detection. Epidermal growth factor receptor(EGFR) gene mutation is an important driving factor in non-small cell lung cancer(NSCLC). Compared with traditional chemotherapy, EGFR-targeted therapy shows significant safety and efficacy. However, not all patients with EGFR mutations are eligible for EGFR-targeted therapy, and different types of mutations often indicate different clinical outcomes, such as the sensitive mutations EGFR 19-Del, L858 R, and the resistance mutation. In addition, the third-generation TKI drugs Osimertinib(AZD9291) and Rociletinib(CO-1686) have been developed to further benefit patients with primary TKI resistance caused by T790 M mutation of EGFR. Therefore, detection of the EGFR mutation status of patients before treatment, and continuously monitoring the mutation of drug resistance genes during the treatment process is useful for the management of targeted drugs in NSCLC patients. In recent years, the rapid development of "liquid biopsy" technology has made it possible to use non-invasive methods to monitor drug resistance mutations in real time. In this paper, we reviewed the clinical application of various non-invasive detection techniques for EGFR mutations in NSCLC in different liquid samples.

关 键 词：肺肿瘤 表皮生长因子受体 液体活检 呼出气冷凝液 

分 类 号：R734.2[医药卫生—肿瘤]