非小细胞肺癌患者表皮生长因子受体和PIK3CA基因突变与临床病理特征和预后的关系  

Relationships of epidermal growth factor receptor and PIK3CA genes mutation with clinicopathological characteristics and prognosis in patients with non-small cell lung cancer

作　　者：何燕[1] 麻文菁 李进辉[3] 陶孟瑶[2] 张婷[2] 田理[4] 吴桂辉 HE Yan;MA Wen-jing;LI Jin-hui;TAO Meng-yao;ZHANG Ting;TIAN Li;WU Gui-hui(Department of Respiratory Medicine,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610072,China;Adverse Drug Reaction Monitoring Center,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610072,China;Department of Pathology,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610072,China;Department of Otorhinolaryngology,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610072,China;Department of Tuberculosis,Chengdu Public Health Clinical Medical Center,Chengdu,Sichuan 610061,China)

机构地区：[1]成都中医药大学附属医院呼吸内科,四川成都610072 [2]成都中医药大学附属医院药品不良反应监测中心,四川成都610072 [3]成都中医药大学附属医院病理科,四川成都610072 [4]成都中医药大学附属医院耳鼻喉科,四川成都610072 [5]成都市公共卫生临床医疗中心结核病科,四川成都610061

出　　处：《中华实用诊断与治疗杂志》2021年第6期576-579,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家重点研发计划课题项目(2019YPC1712502)。

摘　　要：目的观察非小细胞肺癌(non-small cell lung cancer,NSCLC)患者癌组织表皮生长因子受体(epidermal growth factor receptor,EGFR)、磷脂酰肌醇-4,5-二磷酸3-激酶催化亚基α(phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha,PIK3CA)基因突变状况,探讨EGFR、PIK3CA基因突变状态与临床病理特征及预后的关系。方法206例NSCLC患者,应用突变阻滞扩增系统检测NSCLC癌组织EGFR、PIK3CA基因外显子突变情况,分析EGFR、PIK3CA基因突变与临床病理特征的关系。随访1~36个月,采用Kaplan-Meier生存曲线分析不同EGFR、PIK3CA基因突变状态患者的预后情况。结果206例NSCLC患者EGFR基因突变70例,突变率为34.0%;PIK3CA基因突变29例,突变率为14.1%。NSCLC患者中有吸烟史、鳞癌患者EGFR基因突变率(20.79%、12.00%)低于无吸烟史、腺癌患者(46.67%、41.03%)(P<0.05),临床分期Ⅲ~Ⅳ期患者PIK3CA基因突变率(26.32%)高于Ⅰ~Ⅱ期患者(9.40%)(P<0.05)。随访1~36(26.7±5.5)个月,随访期间死亡80例。EGFR基因突变型患者3年总体生存率(80.0%)高于EGFR基因野生型患者(51.5%)(P<0.05),生存时间[(34.1±6.2)个月]长于EGFR基因野生型患者[(21.1±5.4)个月](P<0.05);PIK3CA基因突变型患者3年总体生存率(34.5%)低于PIK3CA基因野生型患者(65.5%)(P<0.05),生存时间[(18.9±5.6)个月]短于PIK3CA基因野生型患者[(28.6±5.2)个月](P<0.05)。结论NSCLC患者存在EGFR基因突变者采用靶向治疗可改善其生存预后,延长生存时间;存在PIK3CA基因突变提示预后不良。Objective To observe the mutation status of epidermal growth factor receptor(EGFR)and phosphatidylinositol-4,5-diphosphate 3-kinase catalytic subunitα(PIK3 CA)genes,and to investigate their relationships with pathological characteristics and prognosis of patients with non-small cell lung cancer(NSCLC).Methods Mutation augmentation block system was used to detect the mutations of EGFR and PIK3 CA gene exons in cancer tissues from 206 NSCLC patients.The relationships of EGFR and PIK3 CA genes mutation with clinicopathological characterists were analyzed.The patients were followed up for 1 to 36 months.The prognosis of patients with different mutation status of EGFR and PIK3 CA genes was analyzed by Kaplan-Meier survival analysis.Results Among 206 NSCLC patients,70 patients developed EGFR mutation,with the mutation rate of 34.0%,and 29 patients developed PIK3 CA mutation,with the mutation rate of 14.1%.The EGFRgene mutation rates were lower in NSCLC patients with a history of smoking and squamous cell carcinoma(20.79%,12.00%)than those in patients without smoking history and with adenocarcinoma(46.67%,41.03%)(P<0.05).The PIK3 CA gene mutation rate was higher in patients with stageⅢ-Ⅳ(26.32%)than that in patients with stageⅠ-Ⅱ(9.40%)(P<0.05).In the follow-up of 1 to 36(26.7±5.5)months,80 patients died.The 3-year overall survival rate of EGFR gene mutant patients(80.0%)was higher than that of EGFR gene wild-type patients(51.5%)(P<0.05),and the survival time was longer in EGFRgene mutant patients((34.1±6.2)months)than that in EGFRgene wild-type patients((21.1±5.4)months)(P<0.05).The 3-year overall survival rate of PIK3 CA gene mutant patients(34.5%)was lower than that of PIK3 CA gene wild-type patients(65.5%)(P<0.05),and the survival time was shorter in PIK3 CA gene mutant patients((18.9±5.6)months)than that in PIK3 CA gene wild-type patients((28.6±5.2)months)(P<0.05).Conclusion Targeted therapy can improve the prognosis and prolong the survived time of NSCLC patients with EGFRgene mutation.PIK3 CAgene mu

关 键 词：非小细胞肺癌 表皮生长因子受体 磷脂酰肌醇-4 5-二磷酸3-激酶催化亚基α 

分 类 号：R734.2[医药卫生—肿瘤]