摘要
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（χ2=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（χ2=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（χ2=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Cyril一1相关（x。=5．436～16．839，P=0．000—0．023），ERCCl蛋白阳性表达、鳞状细胞癌抗原及c咖21．1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。
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 non-small 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 （χ2 = 53.490, P = 0.000）, smoking （ χ2 = 48. 568, P = 0. 000） , non-adenocarcinoma （ χ2 = 105. 560, P = 0. 000 ） and more than 60 years old （χ2= 6. 057, P = 0. 017）. Disease free survival （DFS） of the wild group was better than mutation group （χ2= 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 （＋） （χ2 =6.739,P=0.012）, SCC（χ2=16.839, P=0.000） and Cyfra21-1 （ χ2 = 6. 638, P = 0. 013 ） more than normal value was common in wild group. Increased CEA was common in mutation group （χ2 = 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 research.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2012年第12期1082-1086,共5页
Chinese Journal of Surgery
关键词
癌
非小细胞肺
肺肿瘤
受体
表皮生长因子
突变
无病生存
Carcinoma, non-small-cell lung
factor
Mutation
Disease-free survival predict the mutation status, which need further Lung neoplasms
Receptor, epidermal growth
