晚期非小细胞肺癌一线化疗敏感性与EGFR、KRAS基因状态的关系  

Relationship between first-line chemosensitivity and gene status of EGFR and KRAS in advanced non-small cell lung cancer

作　　者：胡江苇 项信青[1] 楼国梁[1] 管伟[1] 何俊明[1] HU Jiangwei;XIANG Xinqing;LOU Guoliang;GUAN Wei;HE Junming(Department of cardiothoracic surgery,Yiwu Central Hospital,Yiwu 322000,China)

机构地区：[1]义乌市中心医院心胸外科,浙江义乌322000

出　　处：《健康研究》2020年第4期417-420,共4页Health Research

摘　　要：目的探讨分析晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)一线化疗敏感性与EGFR、KRAS基因状态的关系。方法选取晚期NSCLC患者178例,均采取一线化疗药物治疗,检测患者EGFR、KRAS基因突变情况,分析EGFR、KRAS基因状态与临床特征、化疗疗效及无进展生存情况的关系。结果178例患者中检出EGFR突变33例,突变率为18.54%;检出KRAS突变28例,突变率为15.73%;鳞癌与非鳞癌患者EGFR基因突变比例比较,差异有统计学意义(P<0.05)。EGFR突变型患者ORR(48.48%)、DCR(78.79%)分别高于EGFR野生型患者(29.66%、57.24%),KRAS突变型患者ORR(14.29%)、DCR(42.86%)分别低于KRAS野生型患者(36.67%、64.67%),差异均有统计学意义(P<0.05)。EGFR突变型患者中位无进展生存期(12.31个月)优于EGFR野生型(7.28个月),KRAS野生型患者中位无进展生存期(8.57个月)优于KRAS突变型(6.12个月),差异均有统计学意义(P<0.05)。结论EGFR突变型晚期NSCLC患者一线化疗方案疗效高于EGFR野生型患者,KRAS突变型晚期NSCLC患者一线化疗方案疗效低于KRAS野生型患者,EGFR突变可能是晚期NSCLC患者预后的保护性因素,KRAS突变可能是晚期NSCLC患者预后的负性因素。Objective To investigate the relationship between the sensitivity of first-line chemotherapy and the status of EGFR and KRAS genes in advanced non-small cell lung cancer(NSCLC).Methods One hundred and seventy-eight patients with advanced NSCLC in the hospital were selected who received first-line chemotherapy.The mutations of EGFR and KRAS genes were detected.The relationship between the status of EGFR and KRAS genes and clinical characteristics,chemotherapy efficacy,and progression-free survival was analyzed.Results Among 178 patients,33 were found to have EGFR mutation,the mutation rate of the EGFR gene was 18.54%,28 were KRAS mutation,the mutation rate of the KRAS gene was 15.73%.Comparison of EGFR gene mutations between squamous cell carcinoma and non-squamous cell carcinoma(P<0.05),ORR(48.48%)and DCR(78.79%)of EGFR mutant patients were higher than those of EGFR wild-type patients ORF(29.66%)and DCR(57.24%),the difference was statistically significant(P<0.05).ORR(14.29%)and DCR(42.86%)of KRAS mutant patients were lower than KRAS wild-type patients ORR(36.67%)and DCR(64.67%),the differences were statistically significant(P<0.05).The median progression-free survival patients of EGFR mutants(12.31 months)was superior to that of EGFR wild-type(7.28 months).The median progression-free survival(8.57 months)of KRAS wild-type patients was superior to that of KRAS mutants(6.12 months)the differences were statistically significant(P<0.05).Conclusions The efficacy of first-line chemotherapy in patients with EGFR mutant advanced non-small cell lung cancer is significantly higher than that in patients with wild-type EGFR.The efficacy of first-line chemotherapy in patients with KRAS mutant advanced non-small cell lung cancer is significantly lower than that in patients with wild-type KRAS.EGFR mutation is a protective factor for the prognosis of patients,while KRAS mutation is a negative factor for the prognosis of patients.

关 键 词：晚期非小细胞肺癌 一线化疗 化疗敏感性 EGFR KRAS 

分 类 号：R734.2[医药卫生—肿瘤]