肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
Cancer Research and Clinic
2015年
10期
649-654
,共6页
癌,非小细胞肺%高密度脂蛋白胆固醇%表皮生长因子受体%酪氨酸激酶抑制剂%分子靶向治疗%抗药性,肿瘤
癌,非小細胞肺%高密度脂蛋白膽固醇%錶皮生長因子受體%酪氨痠激酶抑製劑%分子靶嚮治療%抗藥性,腫瘤
암,비소세포폐%고밀도지단백담고순%표피생장인자수체%락안산격매억제제%분자파향치료%항약성,종류
Carcinoma,non-small-cell lung%High density lipoprotein cholesterol%Epidermal growth factor%Tyrosine kinase inhibitors%Molecular targeted therapy%Drug resistance,neoplasm
目的 探讨晚期非小细胞肺癌(NSCLC)患者血清高密度脂蛋白胆固醇(HDL-C)水平与表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)耐药的相关性.方法 纳入EGFR突变阳性且一线接受EGFR-TKI治疗的87例NSCLC患者,使用Kaplan-Meier法以及Cox比例风险模型评估治疗前不同血清HDL-C基线水平与EGFR-TKI疗效及耐药相关性.结果 与HDL-C水平降低(＜0.94 mmol/L)患者相比,HDL-C正常水平(≥0.94 mmol/L)患者具有更好的疾病控制率[94.5 ％(52/55)比65.7％(21/32),P＜ 0.001].单因素回归分析显示HDL-C正常组无进展生存期(PFS)更长(HR=0.27,95％CI0.164 ～ 0.444,P＜ 0.001);多因素Cox回归分析显示在不同性别、病理类型、吸烟史、突变类型中,只有不同HDL-C水平组患者PFS差异有统计学意义(P＜0.001),在不同性别和吸烟史中,HDL-C亦与耐药患者PFS相关(女性:P＜ 0.001,男性:P=0.002;吸烟:P＜ 0.001,不吸烟:P=0.014).结论 HDL-C基线水平正常晚期NSCLC患者EGFR-TKI疗效好,出现耐药时间晚,更能从EGFR-TKI治疗中获益.
目的 探討晚期非小細胞肺癌(NSCLC)患者血清高密度脂蛋白膽固醇(HDL-C)水平與錶皮生長因子受體酪氨痠激酶抑製劑(EGFR-TKI)耐藥的相關性.方法 納入EGFR突變暘性且一線接受EGFR-TKI治療的87例NSCLC患者,使用Kaplan-Meier法以及Cox比例風險模型評估治療前不同血清HDL-C基線水平與EGFR-TKI療效及耐藥相關性.結果 與HDL-C水平降低(＜0.94 mmol/L)患者相比,HDL-C正常水平(≥0.94 mmol/L)患者具有更好的疾病控製率[94.5 ％(52/55)比65.7％(21/32),P＜ 0.001].單因素迴歸分析顯示HDL-C正常組無進展生存期(PFS)更長(HR=0.27,95％CI0.164 ～ 0.444,P＜ 0.001);多因素Cox迴歸分析顯示在不同性彆、病理類型、吸煙史、突變類型中,隻有不同HDL-C水平組患者PFS差異有統計學意義(P＜0.001),在不同性彆和吸煙史中,HDL-C亦與耐藥患者PFS相關(女性:P＜ 0.001,男性:P=0.002;吸煙:P＜ 0.001,不吸煙:P=0.014).結論 HDL-C基線水平正常晚期NSCLC患者EGFR-TKI療效好,齣現耐藥時間晚,更能從EGFR-TKI治療中穫益.
목적 탐토만기비소세포폐암(NSCLC)환자혈청고밀도지단백담고순(HDL-C)수평여표피생장인자수체락안산격매억제제(EGFR-TKI)내약적상관성.방법 납입EGFR돌변양성차일선접수EGFR-TKI치료적87례NSCLC환자,사용Kaplan-Meier법이급Cox비례풍험모형평고치료전불동혈청HDL-C기선수평여EGFR-TKI료효급내약상관성.결과 여HDL-C수평강저(＜0.94 mmol/L)환자상비,HDL-C정상수평(≥0.94 mmol/L)환자구유경호적질병공제솔[94.5 ％(52/55)비65.7％(21/32),P＜ 0.001].단인소회귀분석현시HDL-C정상조무진전생존기(PFS)경장(HR=0.27,95％CI0.164 ～ 0.444,P＜ 0.001);다인소Cox회귀분석현시재불동성별、병리류형、흡연사、돌변류형중,지유불동HDL-C수평조환자PFS차이유통계학의의(P＜0.001),재불동성별화흡연사중,HDL-C역여내약환자PFS상관(녀성:P＜ 0.001,남성:P=0.002;흡연:P＜ 0.001,불흡연:P=0.014).결론 HDL-C기선수평정상만기NSCLC환자EGFR-TKI료효호,출현내약시간만,경능종EGFR-TKI치료중획익.
Objective To explore the relevance of high density lipoprotein cholesterol (HDL-C) level and resistance of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in advanced non-small cell lung cancer (NSCLC).Methods In a total of 87 NSCLC patients harboring EGFR mutation treated with EGFR-TKI, the correlations of pre-treatment levels of soluble HDL-C between efficacy and resistance of EGFR-TKI were analyzed by Kaplan-Meier method and Cox proportional hazard model.Results Patients with normal HDL-C (≥0.94 mmol/L) had a better disease control rate (DCR) than those with low HDL-C (＜0.94 mmol/L) [94.5 ％ (52/55) vs 65.7 ％ (21/32), P ＜ 0.001].The results of univariate analysis showed that patients with normal HDL-C had longer progress free survival (PFS) (HR =0.27, 95 ％ CI 0.164-0.444, P ＜ 0.001).The results of multivariate Cox proportional hazard model analysis with sex, pathologic histology, smoking history and mutation type showed that only HDL-C group had a significant difference (P ＜ 0.001).The same results were showed when stratified by sex and smoking history (female: P ＜ 0.001, male: P =0.002;Smoker: P ＜ 0.001, non-smoker: P =0.014).Conclusion Normal pre-treatment serum levels of HDL-C are associated with a better outcome and longer progression-free survival in NSCLC patients treated with EGFR-TKI, which may be a predictive marker for a better response.
