NSCLC患者胸腔积液ROS1、EGFR基因突变与临床病理及靶向治疗的关系研究  

Relationship between ROS1,EGFR gene mutation in pleural effusion andclinicopathology and targeted therapy of NSCLC patients

作　　者：伍秉翔 杨雪荣 刘龙 WU Bingxiang;YANG Xuerong;LIU Long(Department of Oncology,Tianyou Hospital,Shanghai 200061,China;Department of Traditional Chinese Medicine,Tianyou Hospital,Shanghai 200061,China)

机构地区：[1]上海天佑医院肿瘤科,上海200061 [2]上海天佑医院中医科,上海200061

出　　处：《检验医学与临床》2023年第15期2250-2255,共6页Laboratory Medicine and Clinic

摘　　要：目的 探究非小细胞肺癌(NSCLC)患者胸腔积液肉瘤致癌因子-受体酪氨酸激酶(ROS1)、表皮生长因子受体(EGFR)基因突变与临床病理及靶向治疗的关系。方法 选取2018年10月至2021年2月上海天佑医院收治的285例NSCLC患者作为研究对象,均抽取胸腔积液,其中197例患者采用靶向治疗(靶向治疗组),88例患者采用传统化疗(化疗组),通过突变扩增系统-聚合酶链反应(ARMS-PCR)检测患者胸腔积液ROS1、EGFR基因突变情况。分析胸腔积液ROS1、EGFR基因突变与NSCLC患者临床特征及治疗效果的关系。结果 NSCLC患者胸腔积液ROS1基因突变率为3.51%(10/285),EGFR基因突变率为41.05%(117/285)。女性NSCLC患者ROS1、EGFR基因突变率高于男性NSCLC患者(P<0.05);腺癌NSCLC患者ROS1、EGFR基因突变率高于非腺癌NSCLC患者(P<0.05);无吸烟史的NSCLC患者ROS1、EGFR基因突变率高于有吸烟史的NSCLC患者(P<0.05)。ROS1基因突变阳性NSCLC患者中,靶向治疗组客观缓解率(ORR)、疾病控制率(DCR)与化疗组比较,差异无统计学意义(P>0.05)。EGFR基因突变阳性NSCLC患者中,靶向治疗组ORR、DCR分别为61.25%、80.00%,均高于化疗组的32.43%、51.35%,差异均有统计学意义(P<0.05)。ROS1基因突变阳性的NSCLC患者靶向治疗组不良反应发生率与化疗组比较,差异无统计学意义(P>0.05),EGFR基因突变阳性的NSCLC患者靶向治疗组恶心/呕吐、肝损害、骨髓抑制不良反应发生率均低于化疗组(P<0.05)。结论 NSCLC患者胸腔积液检测可见ROS1、EGFR基因突变,其与患者临床特征(性别、病理分型和吸烟史)、疗效及不良反应有关。Objective To explore the relationship between ROS proto-oncogene 1-receptor tyrosine kinase(ROS1)and epidermal growth factor receptor(EGFR)gene mutations and clinicopathologic and targeted therapy in patients with non-small cell lung cancer(NSCLC)in pleural effusion.Methods A total of 285 patients with NSCLC in Tianyou Hospital from October 2018 to February 2021 were selected as the research subjects,all of whom underwent pleural fluid extraction,including 197 patients treated with targeted therapy(targeted therapy group)and 88 patients treated with traditional chemotherapy(chemotherapy group),and the patients′pleural fluid ROS1 and EGFR gene mutations were detected by mutation amplification system-polymerase chain reaction(ARMS-PCR).The relationship between the ROS1 and EGFR gene mutations in pleural effusion and the clinical characteristics and treatment effect of NSCLC patients was analyzed.Results The mutation rate of ROS1 gene in NSCLC patients with pleural effusion was 3.51%(10/285),and the mutation rate of EGFR gene was 41.05%(117/285).The mutation rates of ROS1 and EGFR genes in female NSCLC patients were higher than those in male NSCLC patients(P<0.05);the mutation rates of ROS1 and EGFR genes in adenocarcinoma NSCLC patients were higher than those in non-adenocarcinoma NSCLC patients(P<0.05);the mutation rates of ROS1 and EGFR genes in NSCLC patients without smoking history were higher than those in NSCLC patients with smoking history(P<0.05).In ROS1 mutation-positive NSCLC patients,there were no significant differences in objective remission rate(ORR)and disease control rate(DCR)between the targeted therapy group and the chemotherapy group(P>0.05).In EGFR mutation-positive NSCLC patients,ORR and DCR in targeted therapy group were 61.25%and 80.00%,respectively,higher than 32.43%and 51.35%in chemotherapy group(P<0.05).There was no statistical significance in the incidence of adverse reactions in patients with NSCLC complicated with ROS1 gene mutations between the targeted therapy group and the chemothe

关 键 词：非小细胞肺癌 胸腔积液 肉瘤致癌因子-受体酪氨酸激酶 表皮生长因子受体 基因突变 临床特征 

分 类 号：R734.2[医药卫生—肿瘤]