血脂与接受EGFR-TKIs治疗的Ⅳ期非小细胞肺癌患者预后的相关性  

Correlation between blood lipids and prognosis of stage IV non-small cell lung cancer patients treated with EGFR-TKIs

作　　者：杨思仪 张颖 韩磊 YANG Siyi;ZHANG Ying;HAN Lei(Department of Medical Oncology,Daxing Teaching Hospital,Capital Medical University,Beijing 102600,China)

机构地区：[1]首都医科大学大兴教学医院肿瘤内科,北京102600

出　　处：《现代肿瘤医学》2024年第12期2208-2213,共6页Journal of Modern Oncology

摘　　要：目的:探讨血脂与接受EGFR-TKIs治疗的IV期非小细胞肺癌(non-small cell lung cancer, NSCLC)患者生存预后的相关性。方法:回顾性收集EGFR-TKIs治疗的IV期EGFR突变的NSCLC患者的临床资料、首次治疗前血脂[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)]水平,随访无疾病进展生存期(PFS)和总生存期(OS),用Rstudio(survminer包)软件确定治疗前各血脂最佳截断值,Kaplan-Meier法绘制生存曲线,COX回归分析影响患者PFS、OS的预后因素。结果:共纳入90例NSCLC患者,19外显子缺失41例,21外显子L858R阳性39例,其他类型突变10例;接受埃克替尼、吉非替尼或其他EGFR-TKIs作为首次抗肿瘤治疗的患者分别为31例、41例、18例。治疗前TC≥4.08mmol/L、HDL-C≥1.20 mmol/L组较对照组PFS和OS延长(P <0.001),多因素COX风险模型分析显示初治前血清TC、HDL-C高水平组是接受EGFR-TKIs治疗IV期NSCLC患者PFS、OS的独立预后因素(P值均<0.001)。结论:治疗前高血清TC、HDL-C是接受EGFR-TKIs靶向治疗的IV期NSCLC患者PFS、OS的保护性因素,并有可能成为潜在预测指标。Objective:To investigate the correlation between blood lipids and survival prognosis of stage IV non-small cell lung cancer(NSCLC)patients treated with EGFR-TKIs.Methods:We retrospectively collected clinical history data,pre-first treatment lipid levels,including total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL-C)and low-density lipoprotein(LDL-C)of stage IV NSCLC patients treated with EGFR-TKIs,and followed up disease progression-free survival(PFS)and overall survival(OS).Rstudio(survminer package)software was used to determine the optimal cut-off value of each blood lipid before treatment.Kaplan-Meier method was used to draw survival curves,and COX regression was used to analyze the prognostic factors affecting patients'PFS and OS.Results:A total of 90 NSCLC patients were included,including 41 cases with exon 19 deletion,39 cases with exon 21 L858R positivity,and 10 cases with other types of mutations.31,41,and 18 patients received lcotinib,gefitinib,or other EGFR-TKIs as their first antitumor therapy,respectively.PFS and OS were prolonged in the pre-treatment TC≥4.08 mmol/L and HDL-C≥1.20 mmol/L group compared with the control group(P<0.001),and multifactorial COX risk modeling analyses showed that the group with high levels of serum TC and HDL-C prior to the initial treatment was an independent prognostic factor for PFS and OS in patients with stage IV NSCLC who were treated with EGFR-TKIs(both P values<0.001).Conclusion:High serum TC and HDL-C before treatment are protective factors for PFS and OS in patients with stage IV NSCLC treated with EGFR-TKIs targeted therapy and may be potential predictors.

关 键 词：血脂 非小细胞肺癌 EGFR-TKIS 靶向治疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]