伴EGFR突变肺腺癌新病理亚型接受EGFR-TKIs治疗的疗效观察  

Clinical observation of EGFR-TKIs for the novel histological subtypes of lung adenocarcinoma with EGFR mutation

作　　者：蔡忠福[1] 余宗阳[2] 欧阳学农[2] 张妍[2] 张江灵[1] 

机构地区：[1]解放军第180医院肿瘤血液科,福建泉州362000 [2]南京军区福州总医院肿瘤科,350025

出　　处：《临床肿瘤学杂志》2015年第7期642-645,共4页Chinese Clinical Oncology

摘　　要：目的肺腺癌EGFR突变不同病理亚型与表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)的疗效相关性。方法回顾性分析福州总医院2009年6月1日至2012年12月30日接受EGFR-TKIs治疗83例EGFR突变阳性晚期肺腺癌患者的病理亚型及其与EGFR-TKIs的疗效关系。病理亚型分型基于2011年肺腺癌国际多学科分类。EGFR突变检测采用PCR扩增阻滞法,疗效评估采用RECIST 1.1版标准。结果 83例肺腺癌患者的疾病控制率(DCR)为77.1%,其中腺泡型为主型的DCR为82.9%,实性为主型的DCR为50%,钉凸样为主型的DCR为92.9%,其他类型(乳头样、微乳头)为主型的DCR为66.7%。83例患者的中位无病进展生存期(PFS)为16.0个月,其中腺泡型为主型的中位PFS为17.0个月,实性为主型的中位PFS为7.0个月,钉凸样为主型的中位PFS存为18.0个月,其他类型为主型(包括乳头为主型和微乳头为主型)的中位PFS为12.0个月。结论接受EGFR-TKIs的EGFR突变肺腺癌患者中,钉突样为主型的DCR和PFS可能是最好的,而实性为主型为最差,对患者进行病理亚型分型有助于预测患者疗效。Objective To investigate the relationship between histological subtypes and the efficacy of epidermal growth factor re- ceptor tyrosine kinase inhixitors（EGFR-TKIs） based on EGFR mutation. Methods Eighty-three cases of EGFR mutations-positive advanced lung adenocarcinoma received the EGFR-TKIs treatment form Jun 1,2009 to Dec 30,2012 from Fuzhou General Hospital of Nanjing Military Region and its relationship with the efficacy of EGFR-TKIs was reviewed. Reclassification was carried out based on 2011 Lung Adenocarcino- ma Classification Standard. EGFR mutation was detected by RT-PCR.According to RECIST 1. 1 standards, the efficacy was assessed.Results The total disease control rate （DCR） of 83 patients was 77. 1%, including alveolar predominant type 82. 9% ,solid-predominant type 50%, like spikes type 92. 9% ,and papillary and micropapillary predominant type 66. 6%.Median progression free survival of 83 patients was 16. 0 months,including alveolar predominant type 17. 0 months,solid predominant type 7. 0 months ,spikes predominant type 18. 0 months,and papil- lary and micrepapillary predominant type 12. 0 months. Conclusion Spikes predominant who accepted EGFR-TKIs has a best DCR and PFS, but solid predominant is the worst.Pathological classification is help for predicitng EGFR-TKIs effect.

关 键 词：肺腺癌 病理分型 EGFR突变 表皮生长因子酪氨酸激酶抑制剂 

分 类 号：R734.2[医药卫生—肿瘤]