摘要
目的探讨非小细胞肺癌(NSCLC)患者外周血游离DNA中表皮生长因子受体(EGFR)基因突变与口服靶向药物疗效的相关性。方法应用RT-PCR技术检测31例晚期非小细胞肺癌患者外周血EGFR基因突变情况,根据检测结果将患者分为EGFR基因突变型组和野生型组,同时口服吉非替尼进行一线治疗,分析外周血EGFR基因突变状态与吉非替尼疗效之间的关系。结果 31例患者的外周血游离DNA中检测出EGFR基因的突变率为41.9%(13/31),13例EGFR突变型患者和10例EGFR野生型患者接受了吉非替尼一线治疗,EGFR突变型和EGFR野生型有效率(RR)分别为61.5%(8/13)和10.0%(1/10);疾病控制率(DCR)分别为69.2%(9/13)和10.0%(1/10);中位PFS则分别为14和7.5个月,2年生存率分别为30.7%(4/13)和0。统计学分析显示,外周血游离DNA中EGFR突变型的NSCLC患者应用靶向药物一线治疗能获得更好疗效。结论外周血游离DNA中的EGFR基因突变的NSCLC患者应用靶向药物治疗效果好,因此,检测外周血DNA中的EGFR基因突变状态可以作为肺癌患者选择靶向药物治疗的主要依据。
Objective To explore the relationship between EGFR mutation in circulating DNA and effectiveness of targeted drug as the first-line therapy in advanced non-small cell lung cancer （NSCLC） patients. Methods Thirty-one patients with advanced NSCLC were treated with gefitinib. The mutation of EGFR in NSCLC circulating DNA was detected by RT-PCR. According to the detected re- suits, patients were divided into mutation group and wild type group, and the relationship between EGFR mutation and the effectiveness of gefitinib was analyzed. Results The rate of EGFR mutation in peripheral blood of 31 patients was 41.9%（ 13/31 ） by RT-PCR. After gefitinib treatment, the overall response rates were 61.5 %（8/13 ） and 10.0% （1/10） in mutation group and wild type group, the disease control rates were 69.2% （ 9/13 ） and 10.0% （ 1/10 ）, the median progression free survival time were 14 months and 7.5 months,and the two-year survival rate were 30.7%（4/13） and 0, respectively. NSCLC patients with EGFR mutations treated by ge- fitinib as the first-line therapy acquired much better effectiveness. Conclusion Determining the mutations of EGFR in peripheral blood of advanced NSCLC patients shows significant value in predicting the outcome of targeted drugs as the first-line therapy.
出处
《山西医科大学学报》
CAS
2015年第7期645-648,共4页
Journal of Shanxi Medical University
基金
徐州市科技计划基金资助项目(XM13B045)
