CAJ | 학술논문

目的探讨表皮生长因子受体(EGFR)突变状态与非小细胞肺癌临床病理因素之间关系并分析EGFR突变与术后非小细胞肺癌患者生存相关性.方法回顾性分析2009年3月至2011年3月经手术切除且经过EGFR突变检测的383例非小细胞肺癌患者,分析EGFR突变状态与临床病理因素,肿瘤标志物及患者预后的关系.结果全部患者检出EGFR突变169例,野生型214例,突变率为44.13％.突变在女性、非吸烟、腺癌以及年龄＜60岁的患者中所占比例分别是63.91％、61.54％、88.76％和62.13％,与男性、吸烟、非腺癌及年龄≥60岁相比,差异均有统计学意义(x2=6.057～105.560,P=0.000～0.017).在生存期方面,野生型无病生存期优于突变型(x2=11.329,P=0.001)；19、21外显子突变的中位无病生存期分别是15个月和13个月,差异无统计学意义(x2=0.962,P=0.327).EGFR突变状态还与切除交叉互补修复基因1(ERCC1)蛋白表达、鳞状细胞癌抗原、癌胚抗原及Cyfra2 1-1相关(x2=5.436 ～ 16.839,P=0.000～0.023),ERCC1蛋白阳性表达、鳞状细胞癌抗原及Cyfra21-1升高多见于EGFR野生型患者,而癌胚抗原升高则多见于突变型患者.结论 EGFR突变在女性、不吸烟、腺癌及年龄＜60岁患者中更多见.术后野生型肺癌患者具有较好的无病生存期.肿瘤标志物对EGFR突变有一定预测作用,尚需进一步研究.
목적 탐토표피생장인자수체(EGFR)돌변상태여비소세포폐암림상병리인소지간관계병분석EGFR돌변여술후비소세포폐암환자생존상관성.방법 회고성분석2009년3월지2011년3월경수술절제차경과EGFR돌변검측적383례비소세포폐암환자,분석EGFR돌변상태여림상병리인소,종류표지물급환자예후적관계.결과 전부환자검출EGFR돌변169례,야생형214례,돌변솔위44.13％.돌변재녀성、비흡연、선암이급년령＜60세적환자중소점비례분별시63.91％、61.54％、88.76％화62.13％,여남성、흡연、비선암급년령≥60세상비,차이균유통계학의의(x2=6.057～105.560,P=0.000～0.017).재생존기방면,야생형무병생존기우우돌변형(x2=11.329,P=0.001)；19、21외현자돌변적중위무병생존기분별시15개월화13개월,차이무통계학의의(x2=0.962,P=0.327).EGFR돌변상태환여절제교차호보수복기인1(ERCC1)단백표체、린상세포암항원、암배항원급Cyfra2 1-1상관(x2=5.436 ～ 16.839,P=0.000～0.023),ERCC1단백양성표체、린상세포암항원급Cyfra21-1승고다견우EGFR야생형환자,이암배항원승고칙다견우돌변형환자.결론 EGFR돌변재녀성、불흡연、선암급년령＜60세환자중경다견.술후야생형폐암환자구유교호적무병생존기.종류표지물대EGFR돌변유일정예측작용,상수진일보연구.
Objectives To investigate the relationship between the epithelial growth factor receptor (EGFR) mutation status and clinicopathological factors,and to analyze the mutation on the effect in nonsmall cell lung cancer (NSCLC) after surgery.Methods The NSCLC patients who were resected and detected EGFR gene from March 2009 to March 2011 were retrospectively reviewed.The relationship between EGFR mutation status and clinicopathological factors,tumor markers,prognostic was analyzed.Results The mutation and the wild group had 169 and 214 patients respectively.EGFR mutation in female,non-smoking,adenocarcinoma and less than 60 years old accounted for 63.91％,61.54％,88.76％ and 62.13％ with statistical significance compared with male (x2 =53.490,P =0.000),smoking (x2 =48.568,P =0.000),non-adenocarcinoma (x2 =105.560,P =0.000) and more than 60 years old (x2 =6.057,P =0.017).Disease free survival (DFS) of the wild group was better than mutation group (x2 =11.329,P =0.001).In addition,there were some relations between mutation status and excision repair cross complementing (ERCC1) protein,carcinoembryonic antigen (CEA),squamous cell carcinoma (SCC) and Cyfra21-1.ERCC1 (+) (x2 =6.739,P=0.012),SCC(x2 =16.839,P=0.000) and Cyfra21-1 (x2 =6.638,P =0.013) more than normal value was common in wild group.Increased CEA was common in mutation group (x2 =5.436,P =0.023).Conclusions EGFR mutation is commonly found in female,non-smoking,adenocarcinoma and less than 60 years old NSCLC patients.The wild group obtains better DFS than mutation group.Tumor markers may predict the mutation status,which need further research.