老年晚期非小细胞肺癌患者循环肿瘤细胞与EGFR-TKI疗效的相关性研究  

Study on relationship between efficacy of EGFR-TKI and circulating tumor cell in elderly patient with advanced non-small cell lung cancer

作　　者：何文杰[1] 江波[1] 金从国[2] 涂长玲[1] 朱颖[1] 陈晓群[2] 

机构地区：[1]昆明医科大学第三附属医院干部医疗科,昆明650118 [2]昆明医科大学第三附属医院肿瘤研究所,昆明650118

出　　处：《重庆医学》2016年第32期4507-4510,共4页Chongqing medicine

基　　金：云南省科技厅应用基础研究面上项目(2012FB164)

摘　　要：目的 探讨老年晚期非小细胞肺癌患者循环肿瘤细胞（CTC）的表达与表皮生长因子受体-酪氨酸激酶抑制剂（EGFR-TKI）疗效相关性。方法 66例老年晚期非小细胞肺癌的患者,以全部患者CTC表达数值的中位数为分界点,高于中位数的为高表达组,低于中位数的为低表达组均予EGFR-TKI类药物治疗,对其疗效及预后进行对比。生存分析采用Kaplan-Meier法,Log rank法检验及Cox多因素回归分析。结果疗效方面CTC低表达组有效率为53.3%（16/30）;CTC高表达组有效率为27.8%（10/36）,两组差异有统计学意义（P〈0.05）。预后方面CTC低表达组和CTC高表达组,中位总生存时间分别为22.8个月（95%CI：18.9-26.8个月）和18.3月（95%CI：14.8-21.9个月）,中位无进展生存时间分别为11.5个月（95%CI：15.0-8.1个月）和5.6个月（95%CI：2.9-8.2个月）,两组比较差异有统计学意义（P〈0.05）。结论 CTC表达水平的变化与EGFR-TKI治疗的疗效及预后呈负相关,可作为老年晚期非小细胞肺癌患者EGFR-TKI治疗的疗效及预后的预测指标。Objective To investigate the association between the efficacy with epdidermal growth factor receptor-tyrosine ki- nase inhibitor（EGFR-TKI） and the expression of circulating tumor ceils（ CTC）in elderly patient with advanced non-small cell lung cancer（NSCLC）. Methods Sixty-six elderly patients with, advanced NSCLC were included, The median of expression number of CTC in all cases served as the cut-off point. The patients were divided into the CTC high expression group and CTC low expression group according to whether being higher or lower than the median. The two groups were given EGFR-TKKI medication therapy. The effects and prognosis were compared between the two groups. The survival analysis adopted the Kaplan-Meier method, Logrank test and Cox multivariate regression analysis. Results The efficacy rate of theCTC low expression group was 53.3% （16/30）, whereas which of the CTC high expression group was 27.8% （10/36）, the difference was statistically significant（P〈0.05）. The median overall survival time in the CTC low expression group and CTC high expression group were 22.8 months（95%CI： 18.9- 26.8 months）and 18. 3 months（95%CI： 14.8-21.9 months）respectively. The median progression-free survival time was 11.5 months（95%CI：15.0- 8. 1 months）and 5.6 months（95%CI：2.9 8. 2 months）respectively, the difference between the two groups was statistically significant（P〈0.05）. Conclusion The change of CTC expression level is negatively correlated with the ef- ficacy and prognosis of EGFR-TKI therapy and can serve as the predictive indexes of efficacy and prognosis in elderly patients with advanced NSCLC

关 键 词：癌 非小细胞肺 循环肿瘤细胞 表皮生长因子受体-酪氨酸激酶抑制剂 

分 类 号：R734.2[医药卫生—肿瘤]