非小细胞肺癌中EGFR突变与EGFR-TKI临床敏感性及耐药性之间的相关性研究  

Study on the Correlation of EGFR Mutation with the Clinical Sensitivity and Drug Resistance of EGFR-TKI in Non-small Cell Lung Cancer

作　　者：王旭[1] 袁五营[1] 徐文举 Wang Xu;Yuan Wuying;Xu Wenju(Department of Thoracic Surgery, Henan Provincial Thoracic Hospital, Zhengzhou 450000, China)

机构地区：[1]河南省胸科医院胸外科,郑州450000

出　　处：《成都医学院学报》2020年第2期227-231,共5页Journal of Chengdu Medical College

基　　金：河南省科技攻关计划项目(No:172102310305)。

摘　　要：目的探讨非小细胞肺癌中EGFR突变与EGFR-TKI临床敏感性及耐药性之间的相关性。方法选取2017年6月至2018年5月在河南省细胞医院胸外科确诊的非小细胞肺癌患者67例作为研究对象,均行病理组织检查确诊,取病灶组织采用荧光PCR法完成组织中EGFR突变测定,根据测定结果将患者分为EGFR突变组与非EGFR突变组。所有患者均给予表皮生长因子受体酪氨酸酶抑制剂(EGFR-TKI)治疗,连续治疗4周期;参考实体肿瘤疗效评价标准1.1版对两组患者疗效率进行评估;采用SPSS Pearson相关性分析软件对非小细胞肺癌中EGFR突变与EGFR-TKI临床敏感性及耐药性进行相关性分析。结果67例患者均完成病灶组织PCR检测,最终确定38例EGFR突变,突变率为56.72%。EGFR突变中排在前2位的分别为19del突变和L858R突变,分别占:44.74%和42.11%;单因素及多因素Logistic分析结果表明:非小细胞肺癌患者中EGFR突变率与年龄、性别及行为状态评分比较,差异无统计学意义(P>0.05);非小细胞肺癌患者中EGFR突变率与TNM分期、肿瘤类型比较,差异统计学意义(P<0.05);EGFR突变组经EGFR-TKI治疗4周期后近期疗效率为73.68%,高于对照组44.83%(P<0.05);SPSS Pearson相关性分析及表明:非小细胞肺癌EGFR突变与EGFR-TKI临床敏感性呈正相关(P<0.05),非小细胞肺癌EGFR突变与EGFR-TKI耐药性呈负相关(P<0.05)。结论非小细胞肺癌中EGFR突变与EGFR-TKI临床敏感性及耐药性存在相关性,加强血浆EGFR基因突变检测能评估预后,指导临床治疗。Objective To investigate the correlation of EGFR mutation with the clinical sensitivity and drug resistance of EGFR-TKI in non-small cell lung cancer.Methods A total of 67 patients with non-small cell lung cancer treated from June of 2017 to May of 2018 were enrolled in the study.All the patients underwent the pathological examination.The lesion tissues were taken to detect the EGFR mutation by fluorescence PCR,and the patients were divided into the EGFR mutation group and EGFR non-mutation group according to the detection results.All the patients were treated with epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)for 4 consecutive treatment cycles.The efficacy rates of the two groups were evaluated by reference to Solid Tumor Efficacy Evaluation Standard Version 1.1.The correlation of EGFR mutation with the clinical sensitivity and drug resistance of EGFR-TKI in non-small cell lung cancer was analyzed by Pearson correlation analysis with the help of the SPSS software.Results All the 67 patients completed the PCR detection of the lesions,and the EGFR mutations were finally identified in 38 cases with the mutation rate of 56.72%.The top 2 EGFR mutations were 19del mutation and L858R mutation with the mutation rate of 44.74%and 42.11%respectively.The results of univariate and multivariate logistic analysis showed that the EGFR mutation rate was not correlated with age,gender and scores of behavioral status in non-small cell lung cancer(P>0.05)and it was correlated with the TNM stage and tumor type(P<0.05).The short-term efficacy rate of the EGFR mutation group was 73.68%after the treatment with EGFR-TKI for 4 cycles,and it was significantly higher than that of the EGFR non-mutation group which was 44.83%(P<0.05).The results of Pearson correlation analysis showed that the EGFR mutation in non-small cell lung cancer was positively correlated with the clinical sensitivity of EGFR-TKI(P<0.05)and negatively correlated with the drug resistance of EGFR-TKI(P<0.05).Conclusion The EGFR mutation was correla

关 键 词：非小细胞肺癌 EGFR突变 表皮生长因子受体酪氨酸酶抑制剂 敏感性 耐药性 相关性 

分 类 号：R605[医药卫生—外科学]