非小细胞肺癌患者组织与血清ctDNA突变频谱的一致性及其相关因素分析  

Consistency of tissue and plasma ctDNA mutation spectrum in patients with non-small cell lung cancer and analysis of related factors

作　　者：李鹤飞[1] 王海波[1] 孙振卿[1] 李贲[1] 李伟[1] 史鸿云[2] 贾友超[3] 张锡轩 LI Hefei;WANG Haibo;SUN Zhenqing;LI Ben;LI Wei;SHI Hongyun;JIA Youchao;ZHANG Xixuan(Department of Thoracic Surgery,Affiliated Hospital of Hebei University,Hebei Baoding 071000,China;Department of Radiotherapy,Affiliated Hospital of Hebei University,Hebei Baoding 071000,China;Department of Oncology,Affiliated Hospital of Hebei University,Hebei Baoding 071000,China)

机构地区：[1]河北大学附属医院胸外科,河北保定071000 [2]河北大学附属医院放疗科,河北保定071000 [3]河北大学附属医院肿瘤内科,河北保定071000

出　　处：《现代肿瘤医学》2021年第17期3023-3026,共4页Journal of Modern Oncology

基　　金：河北省医学科学研究课题计划(编号:20190941)。

摘　　要：目的:探究非小细胞肺癌(NSCLC)患者组织与血清循环肿瘤DNA(ctDNA)突变频谱的一致性及其相关因素分析。方法:选取2019年01月至2019年06月在河北大学附属医院诊断及治疗的NSCLC患者50例,检测所有患者肿瘤组织及ctDNA基因突变情况,同时搜集患者肿瘤相关临床资料,根据基因一致性情况将患者分为一致组与不一致组,使用Logistic回归分析影响一致性的相关因素。结果:肿瘤组织中至少存在一种突变的为96%(48/50),血清中至少存在一种突变的为64%(32/50),组织学与血清ctDNA检测结果一致率为46%(23/50);一致组年龄显著小于不一致组,组织学分级中低分化人数比例、Ⅳ期人数比例、肿瘤>3 cm人数比例、骨转移人数比例显著高于不一致组(P<0.05),多因素Logistic回归分析显示,组织低分化(OR=2.802,P=0.028)、Ⅳ期(OR=8.922,P=0.004)、有骨转移(OR=8.425,P=0.012)是基因突变检测一致性的独立危险因素。结论:NSCLC患者组织与血清ctDNA突变频率一致性受多种因素影响,分化越低,分期越高、伴骨转移的一致性越高。Objective:To explore the consistency of tissue and plasma circulating tumor DNA(ctDNA)mutation spectrum in patients with non-small cell lung cancer(NSCLC)and the analysis of related factors.Methods:From January 2019 to June 2019,a total of 50 NSCLC patients diagnosed and treated in Affiliated Hospital of Hebei University were selected.All patients'tumor tissues and ctDNA gene mutations were detected,and tumor-related clinical data were collected.According to the genetic consistency,the patients were divided into the consistent group and the inconsistent group,and Logistic regression was used to analyze the relevant factors affecting the consistency.Results:At least one mutation in the tumor tissue was found in 96%(48/50),at least one mutation in ctDNA was found in 64%(32/50).The consistency rate of tissue and plasma was 46%(23/50).The age of the consistent group was significantly lower than inconsistent group.The proportion of low differentiation,Ⅳperiod,tumor>3 cm,bone metastases in consistent group were significantly higher than inconsistent group.Low differentiation(OR=2.802,P=0.028),Ⅳperiod(OR=8.922,P=0.004),bone metastasis(OR=8.425,P=0.012)were independent risk factors for the consistency of gene mutation detection.Conclusion:The consistency of mutation frequency between tissues and plasma ctDNA of NSCLC patients is affected by many factors,lower differentiation,higher stage,with bone metastasis,the higher the consistency.

关 键 词：非小细胞肺癌 循环肿瘤DNA 基因突变 相关因素 

分 类 号：R734.2[医药卫生—肿瘤]