非小细胞肺癌患者表皮生长因子受体突变对靶向治疗的疗效影响及生存分析  

Effect of Epidermal Growth Factor Receptor Gene Mutation of Non-small Cell Lung Cancer on Targeted Therapy and Survival

作　　者：凌止鸿 李月明[1] 陈晶[2] 

机构地区：[1]四川省第四人民医院,610016 [2]四川省肿瘤医院,610041

出　　处：《实用癌症杂志》2017年第2期207-209,共3页The Practical Journal of Cancer

摘　　要：目的探讨表皮生长因子受体(EGFR)基因突变对非小细胞肺癌(NSCLC)患者靶向治疗疗效及生存的影响。方法 83例经一线化疗失败的中晚期NSCLC患者,通过基因测序按照是否存在EGFR基因第19或21号外显子突变分为突变型组和野生型组,两组均给予吉非替尼口服治疗,250 mg/次,期间进行其他常规检查和定期随访。分析EGFR突变与患者疗效及生存的关系。结果女性、腺癌、不吸烟的NSCLC患者的突变率高于相应的男性、鳞癌、吸烟的NSCLC患者,差异均有统计学意义(P<0.05),而年龄、TNM分期与EGFR突变无明显相关(P>0.05)。78例患者获得随访,其中突变型组32例,患者治疗的客观有效率(ORR)和疾病控制率(DCR)分别为64.7%和94.1%;明显高于46例野生型组的38.8%和71.4%,差异均有统计学意义(P<0.05)。突变型组患者的无进展生存期(PFS)和中位生存时间分别为7.3个月和16.1个月,均较野生型组患者的3.5个月和8.3个月显著延长(P<0.01)。结论存在EGFR基因第19或21号外显子突变的NSCLC患者对应用吉非替尼治疗较敏感,效果较好,生存时间较长。EGFR基因突变可作为评估NSCLC患者分子靶向治疗疗效及生存的预测因子。Objective To explore the influence of the epidermal growth factor receptor （ EGFR） mutations in patients with non-small cell lung cancer （ NSCLC） on targeted therapy and survival .Methods Analyzed retrospectively 83 cases of first-line chemotherapy failed patients with advanced NSCLC ,according to EGFR gene 19 or 21 exon mutation status ,all subjects were divided into mutation type group and wild type group ,the patients in 2 groups received oral gefitinib ,250 mg/time,conduct on other routine inspection and regular follow-up during the treatment .Analyzed the relationship between EGFR mutations and the curative effect and the survival .Results The mutation rate were higher in female ,adenocarcinoma ,non-smoking NSCLC patients than that in men,squamous carcinoma,smoking NSCLC patients,the differences were statistically significant （P〈0.05）,and age, TNM stage had no obvious relationship with EGFR mutations （P〉0.05）.78 patients received the whole follow-up,32 cases of mutant type group,objective response rate（ORR）and disease control rate（DCR）of treatment of mutant type patients were 64.7%and 94.1%respectively;Which were significantly higher than 38.8%and 71.4%of 46 cases of wild type group ,the differences had statistical significance（all P〈0.05）.Progression-free survival（PFS）and the median survival time in the mutant group were 7.3 months and 16.1 months respectively,which were significantly higher than 3.5 months and 8.3 months in the wild type group （P〈0.01）.Conclusion NSCLC patients of EGFR gene 19 or 21 exon mutation are sensitive to the gefitinib treatment ,the effect is better ,survival time is longer .EGFR gene mutation can be used as the predictors of molecular targeted therapy efficacy and survival of NSCLC patients .

关 键 词：非小细胞肺癌 表皮生长因子受体 基因突变 靶向治疗 生存 

分 类 号：R734.2[医药卫生—肿瘤]