晚期肺癌患者血清EGFR基因突变状态及临床特征  

Correlation Analysis between Serum EGFR Gene Mutation Status and Clinical Characteristics of Patients with Advanced Lung Cancer

作　　者：向玉[1] 刘玉林[1] 吕姣姣 胡容 赵琪林[1] 吴晓伟 XIANG Yu;LIU Yulin;LV Jiaojiao;HU Roxy;ZHAO Qilin;WU Xiaowel(Clinical Laboratory, Central Hospital , Suining 629000 , Sichuan , China;Derartment oU Respiratory Medicinr , the First Afftliated Hospital U Xi nn Jiaotonn Unwersity, Xian 710041, Shaanxi, China)

机构地区：[1]遂宁市中心医院检验科,四川遂宁629000 [2]西安交通大学第一附属医院呼吸科,陕西西安710061

出　　处：《贵州医科大学学报》2019年第4期441-446,共6页Journal of Guizhou Medical University

基　　金：遂宁市科技计划项目(2015s15)

摘　　要：目的:采用二代测序测定肺癌患者血清EGFR基因突变状态分析其与患者临床特征及治疗效果的相关性。方法:非小细胞肺癌患者110例,采用二代测序方法检测患者EGFR基因突变分布情况,并根据二代测序结果,将其分为EGFR突变组(n=37)和EGFR野生组(n=73),比较两组患者在性别、癌症类型、TNM分期、吸烟史等临床特征,比较治疗效果及疾病进展生存期(PFS)。结果:二代测序方法共检测出19del、L858R、L861Q、S768I、G719X 5种EGFR基因突变,所占比例分别为45.95%、43.24%、5.41%、2.70%及2.70%;EGFR突变组中,女性、腺癌、吸烟史患者所占比例较高,差异具有统计学意义(P<0.05);EGFR突变组与EGFR野生组患者在性别、癌症类型、TNM分期及吸烟史比较差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,EGFR基因突变状态与非小细胞肺癌患者的癌症类型、性别、TNM分期及吸烟史有显著相关性(P<0.05);EGFR突变组患者临床有效率明显高于EGFR野生组(54.05%vs 19.18%),PFS明显高于EGFR野生组患者,差异具有统计学意义(P<0.05);EGFR突变组受试者CEA表达水平明显高于EGFR野生组,CA125、CY21-1及SCC-Ag明显低于EGFR野生组,两组比较差异具有统计学意义(P<0.05)。结论:EGFR突变状态与非小细胞肺癌患者性别、癌症类型、肿瘤分期以及吸烟史等临床特征及临床效果密切相关。Objective: To analyze the correlation of therapeutic effects in patients with advanced lung cancer and clinical features with serum EGFR gene mutation status detected by second-generation sequencing. Methods: Based on EGFR mutation status determined by second-generation sequencing, one hundred and ten patients with advanced non-small cell lung cancer were classified into EGFR mutation group(n=37) and the EGFR wild group(WT, n=73). We analyzed the correlation of the gender, lung cancer subtypes, TNM stage, smoking history, and therapeutic effect and disease progression survival time(PFS) with EGFR mutation status. Results: Five types of EGFR gene mutations were detected in these patients, including 19 del(45.95%), L858 R(43.24%), L861 Q(5.41%), S768 I(2.70%) and G719 X(2.70%). In EGFR mutation group, the percentages of female patients or patients with lung adenocarcinoma were statistically more in non-smoking patients than in smoking patients(P<0.05). There were remarkable differences in the gender, lung cancer subtypes, TNM stage and smoking history between EGFR mutation group and EGFR wild group(P<0.05). Multivariate logistic regression analysis showed that the EGFR gene mutation status was significantly correlated with lung cancer subtypes, gender, TNM stage and smoking history of patients with non-small cell lung cancer(P<0.05). The clinical effective rate was significantly higher in EGFR mutation group than that in EGFR wild group(54.05% vs 19.18%), and PFS was significantly higher EGFR mutation group than that in EGFR wild group, and their differences were statistically significant(P<0.05). Moreover, CEA expression level was significantly higher that in EGFR mutation group than in EGFR wild group, while CA125, CY21-1 and SCC-Ag were significantly lower EGFR mutation group than those in EGFR wild group, and the difference was statistically significant(P<0.05). Conclusion: The EGFR mutation status is closely correlated to the clinical features and clinical effects of gender, lung cancer subtypes, tumor stage a

关 键 词：肺肿瘤 受体 表皮生长因子 基因 突变 二代测序 临床特征 

分 类 号：R734.2[医药卫生—肿瘤] Q343.1[医药卫生—临床医学]