中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
4期
586-590
,共5页
魏旭东%李进东%刘宝兴%常玉喜%常栋
魏旭東%李進東%劉寶興%常玉喜%常棟
위욱동%리진동%류보흥%상옥희%상동
癌,非小细胞肺%受体,表皮生长因子%基因突变%蛋白表达%EGFR酪氨酸酶抑制剂
癌,非小細胞肺%受體,錶皮生長因子%基因突變%蛋白錶達%EGFR酪氨痠酶抑製劑
암,비소세포폐%수체,표피생장인자%기인돌변%단백표체%EGFR락안산매억제제
Carcinoma,non-small-cell lung%Receptor,epidermal growth factor%Gene mutation%Protein expression%EGFR tyrosine kinase inhibitor
目的:本研究旨在探讨非小细胞肺癌(NSCLC)患者中表皮生长因子受体(EGFR)基因突变的情况,分析EGFR蛋白表达情况对吉非替尼治疗的指导意义。方法收集140例非小细胞肺癌患者新鲜组织,采用荧光定量PCR法检测EGFR基因突变的状态;同时采用免疫组化SP法检测EGFR蛋白的表达。结果140例患者中,46例患者发生了EGFR基因突变,其基因突变率为33%,主要发生在19号外显子(20例,43.5%)和21号外显子(23例,50.0%)。腺癌突变发生率为50.6%,腺鳞癌突变发生率为87.5%,鳞癌突变发生率为2.5%,大细胞癌突变发生率为5.3%(P=0.000),无吸烟史患者突变率为50%,有吸烟史患者的突变率为20.0%(P=0.005),女性患者突变率为50.0%,男性患者突变率为23.3%(P=0.001)。EGFR蛋白表达阳性组患者的中位无疾病进展生存时间为9个月(95%CI:7.3~10.6个月),EGFR蛋白表达阴性组患者的中位无疾病进展生存时间为5个月(95% CI:3.5~6.4个月)。结论 EGFR基因突变和EGFR蛋白表达情况联合检测对于筛选 EGFR 酪氨酸激酶抑制剂(TKI)治疗敏感人群有帮助,并且也能够帮助预测吉非替尼对于晚期NSCLC的疗效及预后。
目的:本研究旨在探討非小細胞肺癌(NSCLC)患者中錶皮生長因子受體(EGFR)基因突變的情況,分析EGFR蛋白錶達情況對吉非替尼治療的指導意義。方法收集140例非小細胞肺癌患者新鮮組織,採用熒光定量PCR法檢測EGFR基因突變的狀態;同時採用免疫組化SP法檢測EGFR蛋白的錶達。結果140例患者中,46例患者髮生瞭EGFR基因突變,其基因突變率為33%,主要髮生在19號外顯子(20例,43.5%)和21號外顯子(23例,50.0%)。腺癌突變髮生率為50.6%,腺鱗癌突變髮生率為87.5%,鱗癌突變髮生率為2.5%,大細胞癌突變髮生率為5.3%(P=0.000),無吸煙史患者突變率為50%,有吸煙史患者的突變率為20.0%(P=0.005),女性患者突變率為50.0%,男性患者突變率為23.3%(P=0.001)。EGFR蛋白錶達暘性組患者的中位無疾病進展生存時間為9箇月(95%CI:7.3~10.6箇月),EGFR蛋白錶達陰性組患者的中位無疾病進展生存時間為5箇月(95% CI:3.5~6.4箇月)。結論 EGFR基因突變和EGFR蛋白錶達情況聯閤檢測對于篩選 EGFR 酪氨痠激酶抑製劑(TKI)治療敏感人群有幫助,併且也能夠幫助預測吉非替尼對于晚期NSCLC的療效及預後。
목적:본연구지재탐토비소세포폐암(NSCLC)환자중표피생장인자수체(EGFR)기인돌변적정황,분석EGFR단백표체정황대길비체니치료적지도의의。방법수집140례비소세포폐암환자신선조직,채용형광정량PCR법검측EGFR기인돌변적상태;동시채용면역조화SP법검측EGFR단백적표체。결과140례환자중,46례환자발생료EGFR기인돌변,기기인돌변솔위33%,주요발생재19호외현자(20례,43.5%)화21호외현자(23례,50.0%)。선암돌변발생솔위50.6%,선린암돌변발생솔위87.5%,린암돌변발생솔위2.5%,대세포암돌변발생솔위5.3%(P=0.000),무흡연사환자돌변솔위50%,유흡연사환자적돌변솔위20.0%(P=0.005),녀성환자돌변솔위50.0%,남성환자돌변솔위23.3%(P=0.001)。EGFR단백표체양성조환자적중위무질병진전생존시간위9개월(95%CI:7.3~10.6개월),EGFR단백표체음성조환자적중위무질병진전생존시간위5개월(95% CI:3.5~6.4개월)。결론 EGFR기인돌변화EGFR단백표체정황연합검측대우사선 EGFR 락안산격매억제제(TKI)치료민감인군유방조,병차야능구방조예측길비체니대우만기NSCLC적료효급예후。
Objective This study investigated gene mutations of EGFR in Chinese patients with NSCLC,analyzed the protein expression of EGFR and its clinical signify cancer after the treatment of gefitinib. Methods Fluorescent quantitative PCR was used to detect the EGFR gene mutations status, immunohistochemistry was used to detect EGFR protein expression. Results The frequency of EGFR mutations, which were mainly located in exon 19(20 cases,43.5%) and exon 21(23 cases, 50.0%), was 33%.The mutation frequency of adenocarcinoma, adenosquamous carcinoma, squamous carcinoma and large cell carcinoma was 50.6%, 87.5%, 2.5%and 5.3%(P=0.000). The mutation frequency of the patients with no smoking history was 50.0%,by contrast, the mutation frequency of the patients who have a history of smoking was 20.0%(P=0.005). The mutation frequency of the female patients was 50.0%, and the male patients was 23.3%(P=0.001). The median PFS(Progression Free Survival) of patients whose EGFR protein expression was positive was nine months(95% CI: 7.3-10.6 months), and the median PFS of the patiens whose EGFR protein expression was negative was five months(95% CI: 3.5-6.4 months). Conclusion Combined detection of EGFR and protein expression of EGFR can help determined whether the patients may benefit more from EGFR tyrosine kinase inhibitor (EGFR-TKD and also help predict the response and prognosis of gefitinib.