双调蛋白在厄洛替尼治疗EGFR野生型NSCLC中的预后价值研究  

The Prognostic Role of Amphir Egulin in the Treatment of Erlotinib Against Non-small Cell Lung Cancer with Wildtype EGFR

作　　者：丁江华[1] 龚升平 吴小建[3] 谢联斌[1] 

机构地区：[1]解放军171医院血液肿瘤科,江西九江332000 [2]宁波市第一人民医院肿瘤科,浙江宁波315010 [3]九江学院附属医院血液肿瘤科,江西九江332000

出　　处：《临床误诊误治》2016年第4期66-70,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨双调蛋白（Amphiregulin,AREG）在厄洛替尼治疗表皮生长因子受体（epidermal growth factor receptor,EGFR）野生型非小细胞肺癌（non-small cell lung cancer,NSCLC）中的预后价值。方法收集2010年1月—2015年1月解放军171医院、宁波市第一人民医院和九江学院附属医院肿瘤科收治的40例EGFR野生型进展期NSCLC患者,采用免疫组织化学染色法检测AREG表达情况,并分析AREG与厄洛替尼疗效的相关性。结果 40例中AREG阳性26例（AREG阳性组）,AREG阴性14例（AREG阴性组）,AREG表达与年龄存在相关性（χ^2=4.050,P=0.0320）;客观有效率（OR）为22.5%（9/40）,疾病控制率（DCR）为50.0%（20/40）。AREG阳性组DCR显著高于AREG阴性组（61.5%vs 28.6%,P=0.0210）,但两组OR比较无明显差异（26.9%vs 14.3%,P=0.7800）。AREG阳性组无进展生存期及总生存期均明显优于AREG阴性组（7周vs 4周,P=0.0012;11.5个月vs 4个月,P=0.0003）。AREG阳性组皮疹发生率明显高于AREG阴性组（57.7%vs 21.4%,P=0.0350）。结论在EGFR野生型NSCLC患者中,AREG阳性者可从厄洛替尼治疗中获益,且皮疹发生率更高,提示AREG可作为野生型NSCLC患者接受EGFR-酪氨酸激酶抑制剂治疗的潜在分子标志物。Objective To explore the prognostic role of amphiregulin（ AREG） in the treatment of erlotinib against non-small cell lung cancer（ NSCLC） with wild-type epidermal growth factor receptor（ wt-EGFR）. Methods 40 consecutive patients with advanced NSCLC harboring wt-EGFR were collected in this study during Jan. 2010 and Jan. 2015 from the oncology department of the 171 st Hospital of PLA,the affiliated Hospital of Jiujiang University. The AREG expression was determined by immunohistostaining with the aim of investigating the association between AREG level and the effect of erlotinib treatment. Results In the study,the patients with AREG-positive accounted for 65%（ 26 /40）,while 35%（ 14 /40） patients were AREG-negative. The expression of AREG was correlated with the factor of age in patients（ χ^2= 4. 050,P = 0. 0320）.The overall response rate（ OR） was 22. 5%（ 9 /40） and the disease control rate（ DCR） was 50. 0%（ 20 /40） in the patients treated with erlotinib. The DCR in the AREG-positive group was markedly higher than that in the AREG-negative group（ 61. 5% vs 28. 6%,P = 0. 0210）. No significant difference was found in the OR between the two groups（ 26. 9% vs14. 3%,P = 0. 7800）. The AREG-positive group achieved better prolonged progression-free survival（ PFS） and overall survival（ OS） rates than that of the AREG-negative group（ 7 week vs 4 week,P = 0. 0012; 11. 5 month vs 4 month,P =0. 0003）. The incidence rate of skin rash in AREG-positive group was markedly higher than that in AREG-negative group（ 57. 7% vs 21. 4%,P = 0. 0350）. Conclusion The advanced NSCLC patients harboring wt-EGFR with AREG-positive tumors may benefit from erlotinib treatment accompanying higher incidence rate of skin rash,indicating the potential molecularmarker of AREG for the patients with wt-EGFR NSCLC when treated with erlotinib.

关 键 词：双调蛋白 厄洛替尼 癌 非小细胞肺 预后 

分 类 号：R734.2[医药卫生—肿瘤]