非小细胞肺癌患者EGFR、K-ras基因突变与厄洛替尼治疗的相关性研究  

A study on the relationship between EGFR,K-ras gene mutation and the treatment of erlotinib in non-small cell lung cancer patients

作　　者：李秀忠[1] 赵志军[1] 陈娟[1] 翟学峰[1] 赵玥[1] 黄学兰[1] 姚丽[1] 张锦[1] 

机构地区：[1]宁夏医科大学总医院呼吸科,宁夏银川750004

出　　处：《宁夏医学杂志》2014年第9期787-789,I0001,共4页Ningxia Medical Journal

基　　金：宁夏自然科学基金资助项目(NZ10154)

摘　　要：目的研究非小细胞肺癌患者表皮生长因子受体(EGFR)、K-ras基因位点突变与厄洛替尼靶向治疗效果的关系。方法采用PCR、测序等方法检测入选40例患者EGFR、K-ras基因突变情况,确诊入选病例给予厄洛替尼治疗,评价治疗效果与基因突变位点之间的关系。结果疗效好组22例患者中,18外显子突变11例,19外显子突变11例,20外显子突变4例,无K-ras突变;疗效差组18例患者中,18外显子突变2例,19外显子突变1例,20外显子突变10例,K-ras突变8例。疗效好组和疗效差组在EGFR基因18、19、20外显子和K-ras基因突变数量上比较,差异有统计学意义(P<0.05)。结论对厄洛替尼有效组EGFR突变主要集中在18、19外显子上,并无K-ras突变;而无效组的EGFR突变主要集中在20外显子上,并伴有明显的K-ras突变,提示临床非小细胞肺癌厄洛替尼治疗时应关注EGFR、K-ras基因突变的具体情况。Objective To study the relationship between the gene locus mutation of EGFR, K - ras and the targeted therapy effect of Erlotinib in non - small cell lung cancer （NSCLC） patients. Methods The gen mutation of EGFR and K - ras were detected by PCR and sequencing. Patients in this study were treated with Erlotinib. Then treatment effects were evaluated. Results In good outcome group of 22 patients, there were 11 mutation on 18 exon, 11 mutation on 19 exon, and 4 mutation on 20 exon. Moreover, none mutation was found on K -ras gene in this group. In poor outcome group of 18 patients, there were 2 mutation on 18 exon, 1 mutation on 19 exon, and 10 mutation on 20 exon. Moreover, there were 8 mutation found on K - ras gene of this group. Compared with the number of mutations, there was a significant difference between good outcome group and poor outcome group （ P 〈 0.05 ）. Conclusion The mutation in good outcome group with treatment of Erlotinib are focused on the exon of 18 and 19, accompanied with none mutation on K -ras gene. The mutation in poor outcome group is focused on the exon of 20, accompanied with abundant mutation on K - ras gene. The results of this study can prompt clinician who treats NSCLC patients with Erlotinib paying more attention on the genetic loci of EGFR and K - ras.

关 键 词：非小细胞肺癌 表皮生长因子受体 基因突变 厄洛替尼 

分 类 号：R734.2[医药卫生—肿瘤]