TP 53和KRAS基因在非小细胞肺癌免疫治疗中的预后意义  

Prognostic significance of TP 53 and KRAS genes in immunotherapy for non-small cell lung cancer

作　　者：李想[1] 郭永军 LI Xiang;GUO Yongjun(Department of Pathology,Fifth Clinical Medical College of Henan University of Chinese Medicine/Zhengzhou People’s Hospital,Zhengzhou 450004;Department of Molecular Pathology,Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第五临床医学院/郑州人民医院病理科,郑州450004 [2]郑州大学附属肿瘤医院/河南省肿瘤医院分子病理科,郑州450000

出　　处：《临床与病理杂志》2024年第11期1516-1526,共11页Journal of Clinical and Pathological Research

基　　金：河南省重大科技专项(201300310400)。

摘　　要：目的:非小细胞肺癌(non-small cell lung cancer,NSCLC)是肺癌常见的类型,免疫治疗作为晚期NSCLC重要的治疗策略,打开了临床治疗的新格局,但仍有部分患者的免疫治疗效果不够理想,其原因可能与肿瘤的基因突变状态密切相关。本研究旨在探讨NSCLC患者的TP53基因与Kirsten鼠肉瘤基因(Kirsten ratsarcoma viral oncogene homolog,KRAS)状态是否能提供免疫治疗的潜在预后价值。方法:本研究为回顾性研究,纳入对象为2019年1月至2021年6月在郑州大学附属肿瘤医院接受免疫治疗且明确了TP53及KRAS基因状态的87例NSCLC患者。统计纳入患者的TP53/KRAS基因的状态和生存情况,分析TP53/KRAS基因与免疫治疗之间的关系。结果:与TP53/KRAS基因野生型相比,仅TP53或KRAS基因单一突变的晚期NSCLC患者在免疫治疗中获益的可能性较大(P<0.05);与TP53和KRAS基因共突变的晚期NSCLC患者相比,存在TP53或KRAS基因单一突变在免疫治疗中可能具有更好的无进展生存期(P<0.05)。结论:TP53或者KRAS基因单一突变的NSCLC患者在免疫治疗中可能具有更好的预后。Objective:Non-small cell lung cancer(NSCLC)is a common type of lung cancer.Immunotherapy has emerged as a key treatment strategy for advanced NSCLC,revolutionizing clinical management.However,some patients do not respond optimally to immunotherapy,potentially due to the genetic mutation status of the tumor.This study aims to explore whether TP 53 and Kirsten rat sarcoma viral oncogene homolog(KRAS)gene statuses can serve as potential prognostic indicators for NSCLC patients undergoing immunotherapy.Methods:This retrospective study included 87 NSCLC patients with confirmed TP 53 and KRAS gene statuses who received immunotherapy at the Affiliated Cancer Hospital of Zhengzhou University from January 2019 to June 2021.The mutation status of TP 53/KRAS genes and patient survival outcomes were analyzed to evaluate their association with immunotherapy efficacy.Results:Compared with patients with wild-type TP 53/KRAS genes,those with mutations in either TP 53 or KRAS had a significantly higher likelihood of benefiting from immunotherapy(P<0.05).Additionally,patients with a single mutation in TP 53 or KRAS exhibited a longer progression-free survival compared to those with concurrent TP 53 and KRAS mutations(P<0.05).Conclusion:NSCLC patients with a single mutation in TP 53 or KRAS may have a better prognosis when undergoing immunotherapy.

关 键 词：非小细胞肺癌 免疫治疗 基因突变 TP53基因 KRAS基因 

分 类 号：R734.2[医药卫生—肿瘤]