不同病理分期肺腺癌EGFR、ALK基因状态与EGFR-TKI靶向治疗的关系  

The correlation between EGFR,ALK mutation and EGFR-TKI targeted therapy in patients with lung adenocarcinoma

作　　者：宗亮[1] 孙清超[1] 邓彦超[1] 朱辉[1] 张力为[1] 

机构地区：[1]新疆医科大学第一附属医院胸外科,乌鲁木齐8300110

出　　处：《癌症进展》2016年第9期882-884,888,共4页Oncology Progress

摘　　要：目的探讨不同病理分期肺腺癌表皮生长因子受体(EGFR)、间变性淋巴瘤激酶(ALK)基因状态与EGFR-TKI靶向治疗的关系。方法选取接受EGFR-TKI靶向治疗的肺腺癌患者87例,检测患者EGFR、ALK基因状态,分析其与临床特征及疗效的关系。结果 EGFR突变患者与非EGFR突变患者年龄、性别及TNM分期比较,差异无统计学意义(P﹥0.05);EGFR突变患者吸烟比例低于非EGFR突变患者(26.32%vs 48.98%),差异有统计学意义(P﹤0.05);ALK阳性与ALK阴性患者的性别、吸烟比例及TNM分期比较,差异均无统计学意义(P﹥0.05);ALK阳性患者平均年龄低于ALK阴性患者,差异有统计学意义(P﹤0.05);EGFR突变患者EGFR-TKI治疗的总缓解率优于ALK阳性和WT/WT患者,差异均有统计学意义(P﹤0.05);ALK阳性患者和WT/WT患者治疗疗效比较,差异无统计学意义(P﹥0.05)。结论肺腺癌患者应首先进行EGFR检测,如有条件可同时检测EGFR突变和ALK重排;EGFR突变患者应首选EGFR-TKI靶向治疗。Objective To investigate the correlation between the mutation of epidermal growth factor（EGFR）, anaplastic lymphoma kinase（ALK） and EGFR- TKI targeted therapy in lung adenocarcinoma. Method 87 patients with lung adenocarcinoma who received EGFR-TKI targeted therapy were included in the analysis, the EGFR and ALK gene status of all patients were detected, and the correlation with clinical characteristics and efficacy was evaluated. Result There was no significant difference in age, gender and TNM stage between EGFR-positive and EGFR-negative patients（P〉0.05）; The proportion of current smokers in patients with positive EGFR mutation was 26.32%, significantly lower than those with negative EGFR mutation at 48.98%（P〈0.05）; For patients with or without ALK mutations, the distributions of gender, smoker and TNM stages were similar（P〉0.05）; While patients with positive ALK were significantly younger than those with negative ALK（P〈0.05）; The overall response rate of EGFR-TKI treatment in positive EGFR mutation patients was higher than those with positive ALK and WT/WT（P〈0.05）; While there was no significant difference between the clinical efficacy of ALK positive and WT/WT patients（P〉0.05）. Conclusion Lung adenocarcinoma patients should first be detected for EGFR, though EGFR mutations and ALK rearrangement are recommended if available; And EGFR-TKI should be the first-line treatment for patients with positive EGFR mutation.

关 键 词：肺腺癌 表皮生长因子受体 间变性淋巴瘤激酶 EGER-TKI靶向治疗 

分 类 号：R734.2[医药卫生—肿瘤]