CAJ | 학술논문

　　目的：探讨表皮生长因子本酪氨酸激酶抑制剂（EGFR-TKIs）治疗晚期非小细胞肺癌继发耐药的机制。方法：用富集突变PCR (Mutation–enriched PCR)分析46例初治有效且维持≥6个月的晚期非小细胞肺癌患者的外周血和石蜡包埋组织标本的EGFR20外显子T790M突变，分析其与病理特征、疗效、无疾病进展生存时间（PFS）的相关性。结果：46例患者进展期外周血标本中， T790M突变率为39.13%（18/46例），明显高于治疗前标本中5.88%（2/34例）。T790M突变阳性者中位PFS为16.4个月（95%CI：10.83～17.47），野生型患者中位PFS10.2个月（95%CI：10.2～13.47）（P=0.6139）。结论：研究表明T790M突变与EGFR-TKIs继发耐药相关，在非小细胞肺癌患者中存在动态变化，与疗效和生存可能有一定相关性。
　　목적：탐토표피생장인자본락안산격매억제제（EGFR-TKIs）치료만기비소세포폐암계발내약적궤제。방법：용부집돌변PCR (Mutation–enriched PCR)분석46례초치유효차유지≥6개월적만기비소세포폐암환자적외주혈화석사포매조직표본적EGFR20외현자T790M돌변，분석기여병리특정、료효、무질병진전생존시간（PFS）적상관성。결과：46례환자진전기외주혈표본중， T790M돌변솔위39.13%（18/46례），명현고우치료전표본중5.88%（2/34례）。T790M돌변양성자중위PFS위16.4개월（95%CI：10.83～17.47），야생형환자중위PFS10.2개월（95%CI：10.2～13.47）（P=0.6139）。결론：연구표명T790M돌변여EGFR-TKIs계발내약상관，재비소세포폐암환자중존재동태변화，여료효화생존가능유일정상관성。
Objective:To investigate acquired resistance mechanisms of epidermal growth factor receptor tyrosine kinase inhibitors in advanced non-smal cel lung cancer ( NSCLC). Methods:Formalin-fixed, paraffin-embedded biopsy tissues and peripheral blood samples were obtained from advanced NSCLC that caused sensitive tumors to become resistant to EGFR-TKIs.EGFR exon20 T790M mutations were detected by Mutation-enriched PCR. Associations between T790M mutation and clinic-pathologic parameters were analyzed. Results: Rates of T790M mutations before and after EGFR-TKIs treatment were 39.13%(18/46), 5.88%(2/34) ,respectively. The patients with T790M mutations had a longer PFS than those with wild type ( 16.4months vs. 10.2months)(P=0.6139). Conclusion: T790M mutation is associated with acquired resistance of EGFR-TKIs in NSCLC,and may be relevant to tumor response and clinical outcome in the NSCLC patients.