肺腺癌患者EGFR突变与其临床特征及EGFR-TKI一线治疗预后生存的关系  

Correlation Analysis of EGFR Mutation with Clinical Characteristics and Survival after First-line Treatment of EGFR-TKI in Patients with Lung Adenocarcinoma

作　　者：张玮芳 毛山山[1] 李兴[1] ZHANG Weifang;MAO Shanshan;LI Xing(Department of Cancer Chemotherapy,Haikou People′s Hospital,Haikou 570208,China)

机构地区：[1]海口市人民医院肿瘤化疗科,海口570208

出　　处：《医学综述》2023年第18期3725-3730,共6页Medical Recapitulate

基　　金：海南省自然科学基金高层次人才项目(822RC862)。

摘　　要：目的探究肺腺癌患者表皮生长因子受体(EGFR)突变与其临床特征及EGFR-酪氨酸激酶抑制剂(TKI)一线治疗预后生存的关系。方法选取2018年2月至2021年2月海口市人民医院肿瘤化疗科门诊收治的110例肺腺癌患者为研究对象,入组患者均接受EGFR-TKI一线治疗。对所有患者病理组织标本EGFR基因外显子进行检测,对比突变型与野生型的临床特征。分析肺腺癌患者不同基因型及其临床特征与EGFR-TKI一线治疗预后生存的关系。结果110例肺腺癌患者中EGFR突变阳性62例(56.36%),EGFR突变阴性48例(43.64%)。EGFR突变阳性患者中女性、无吸烟史、美国东部肿瘤协作组(ECOG)评分2~3分、胸内转移、远处转移占比均高于EGFR突变阴性患者[64.52%(40/62)比43.75%(21/48)、69.35%(43/62)比43.75%(21/48)、67.74%(42/62)比47.92%(23/48)、80.65%(50/62)比62.50%(30/48)、69.35%(43/62)比47.92%(23/48)](P<0.05或P<0.01)。EGFR突变阳性的肺腺癌患者中位无进展生存期(PFS)、中位总生存期(OS)时间明显长于EGFR突变阴性患者(11个月比5个月、28个月比16个月)(χ^(2)=19.254,P<0.001;χ^(2)=13.136,P<0.001)。Cox单因素及多因素回归分析显示,EGFR突变阳性是PFS和OS的独立影响因素(P<0.01)。结论女性、无吸烟史、ECOG评分2~3分、出现胸内转移及远处转移的肺腺癌患者的EGFR突变可能性较高,而EGFR突变阳性是肺腺癌患者经EGFR-TKI一线治疗后预后生存期的独立影响因素。Objective To explore the relationship between epidermal growth factor receptor(EGFR)mutation and the clinical characteristics and survival after first-line treatment with EGFR-tyrosine kinase inhibitor(TKI)in patients with lung adenocarcinoma.Methods A total of 110 patients with lung adenocarcinoma admitted to the Department of Cancer Chemotherapy of Haikou People′s Hospital from Feb.2018 to Feb.2021 were included in the study,and all the patients received first-line treatment with EGFR-TKI.The exons of EGFR gene were detected in all patients′pathological tissue samples,and the clinical characteristics of mutant and wild type were compared.The relationship of the different genotypes and clinical characteristics of lung adenocarcinoma with the survival prognosis of EGFR-TKI first-line treatment.Results Among the 110 patients,62(56.36%)were EGFR positive and 48(43.64%)were EGFR negative.The proportion of women,no smoking history,Eastern Cooperative Oncology Group(ECOG)score of 2-3,intrathoracic metastasis and distant metastasis in the EGFR mutation-positive patients were significantly higher than those in the EGFR mutation-negative patients[64.52%(40/62)vs 43.75%(21/48),69.35%(43/62)vs 43.75%(21/48),67.74%(42/62)vs 47.92%(23/48),80.65%(50/62)vs 62.50%(30/48),69.35%(43/62)vs 47.92%(23/48)](P<0.05 or P<0.01).Progression-free survival(PFS)and overall survival(OS)of the EGFR-mutation-positive lung adenocarcinoma patients were significantly higher than those of the EGFR-negative lung adenocarcinoma patients(11 months vs 5 months,28 months vs 16 months)(χ^(2)=19.254,P<0.001;χ^(2)=13.136,P<0.001).Cox univariate and multivariate regression analysis showed that EGFR mutation positivity was an independent factor for PFS and OS(P<0.01).Conclusion Female patients with lung adenocarcinoma,no smoking history,ECOG score of 2-3,and intrathoracic and distant metastasis are more likely to have EGFR mutation,and EGFR mutation positive is an independent factor influencing the prognosis and survival of lung adenocarcinoma patient

关 键 词：肺腺癌 表皮生长因子受体 表皮生长因子受体-酪氨酸激酶抑制剂 

分 类 号：R734.2[医药卫生—肿瘤]