PIK3CA对埃克替尼治疗EGFR基因突变的非小细胞肺癌病人的疗效预测  

Predicting the efficacy of taking icotinib in the non-small cell lung cancer patients with EGFR gene mutation by PIK3CA

作　　者：刘海涛[1] 李陆风 李殿明[1] 刘佳慧 LIU Hai-tao;LI Lu-feng;LI Dian-ming;LIU Jia-hui(Department of Respriration and Critical Care,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院呼吸与危重症学科

出　　处：《蚌埠医学院学报》2019年第8期1015-1019,共5页Journal of Bengbu Medical College

基　　金：安徽高校自然科学研究重点项目(KJ2019A0395);蚌埠医学院自然科学研究重点项目(BYKZ1631ZD)

摘　　要：目的:探讨PIK3CA对埃克替尼治疗EGFR基因突变的非小细胞癌(NSCLC)病人疗效预测价值。方法:首先应用ARMS法对确诊肺腺癌标本给予EGFR基因突变检测。对于EGFR检测阳性肺腺癌标本应用免疫组化蛋白定性法进行PIK3CA表达状态分析。对EGFR检测阳性者给予埃克替尼治疗,观察PIK3CA高表达组与低表达组埃克替尼治疗后的无进展生存期(PFS)。结果:在62例EGFR突变的肺癌病人中,48.38%同时存在PIK3CA高表达。在PIK3CA表达阳性病人应用埃克替尼后中位疾病PFS 10.5个月(95%CI:5.6~15.4);PIK3CA表达阴性的病人应用埃克替尼后中位疾病PFS 17.0个月(95%CI:10.1~23.8)。PIK3CA低表达病人用埃克替尼治疗的应答率、中位PFS、EGFR-TKIs耐药率均有较高的趋势(χ~2=7.16,P<0.05)。结论:在EGFR突变的接受埃克替尼治疗的NSCLC病人,检测PIK3CA表达状态有助于鉴别出EGFR-TKIs治疗有效较低的病人,提前进行干预,从而延长病人中位PFS。Objective:To investigate the usage of PIK3CA in predicting the efficacy of taking icotinib in the non-small cell lung cancer(NSCLC)patients with EGFR gene mutation.Methods:First,the ARMS method was used to detect the mutation of EGFR gene in the specimens of lung adenocarcinoma.Then,for EGFR-positive lung adenocarcinoma specimens,immunohistochemistry was used to analyze the expression status of PIK3CA.After that,icotinib was given to EGFR-positive patients,and progression-free survival(PFS)was observed for patients with high-expression PIK3CA and low-expression PIK3CA.Results:Among 62 lung cancer patients with EGFR mutation,48.38%had high expression of PIK3CA.After applying icotinib in PIK3CA-positive patients,the median disease progression-free survival period reached 10.5 months(95%CI:5.6-15.4),and the median disease progression-free survival period for PIK3CA-negative patients taking icotinib was 17.0 months(95%CI:10.1-23.8).The response rate,median PFS,and EGFR-TKIs resistance rates of patients with low expression of PIK3CA increased significantly after taking icotinib,and the differences were significant(X^2=7.16,P<0.05).Conclusions:For the NSCLC patients who have received EGFR-TKIs treatment,the detection of the expression status of PIK3CA can help to identify the patients with low efficacy,so early intervention can be adopted to extend the PFS.

关 键 词：非小细胞肺癌 PIK3CA 埃克替尼 

分 类 号：R734.2[医药卫生—肿瘤]