摘要
目的 探讨埃克替尼治疗对晚期肺癌患者血清EGFR基因19和21表达水平的影响,为临床诊断治疗提供科学参考.方法 68例晚期肺癌患者均接受3个月的埃克替尼治疗,提取患者治疗前后的血清游离DNA,应用RT-PCR技术扩增患者血清DNA中EGFR外显子19和外显子21,应用基因测序法对EGFR基因突变进行测序,评价其疗效及分析治疗前后EGFR基因外显子19和外显子21的突变状态.结果 在68例肺癌患者埃克替尼治疗过程中,病理类型与盐酸埃克替尼疗效相关,腺癌DCR明显高于鳞癌.18例EGFR突变患者中,没有CR及PD病例,PR 11例,SD 7例,ORR 61.1%,DCR 100%,其余50例%GFR状态未知患者中,PR 24例,SD4例,PD 15例,ORR 48.0%,DCR 56.0%.Fisher精确检验显示,2组间ORR的差异无统计学意义.血清EGFR的突变以外显子2l为主,化疗前后外显子19和21的突变率无显著性差异,血清EGFR的突变状态与患者病理类型具有相关性（P〈0.05）,化疗前血清EGFR基因突变率为35.4%（17/48）,化疗后血清EGFR基因突变率为50%,化疗前后患者EGFR基因突变率55%.结论 埃克替尼药物治疗晚期肺癌有疗效,对肺腺癌的效果较好,并且可能会导致肺癌患者血清EGFR基因突变状态的改变.对于一线应用盐酸埃克替尼治疗的患者应该时刻观察血清EGFR基因的变化,避免患者治疗的盲目性.
Objective To investigate the effect of ectectin on the expression of EGFR gene 19 and 21 in patients with advanced lung cancer.Aim to provide scientific reference.Methods68 patients with advanced lung cancer were treated with 3 months of ectectin.Serum free DNA was extracted from patients before and after treatment.RT-PCR was performed to amplify EGFR exon 19 and exon 21, EGFR gene mutations were detected by gene sequencing, and the mutation status of exon 19 and exon 21 of EGFR gene before and after treatment were evaluated.ResultsIn 68 patients with lung cancer before and after treatment with ectatinib, Histopathological types were correlated with the efficacy of ectectin hydrochloride.DCR of adenocarcinoma was significantly higher than that of squamous cell carcinoma.18 cases of EGFR mutations, there is no CR and PD cases, PR 11 cases, SD 7 cases, ORR 61.1%, DCR 100%.In the remaining 50 patients with unknown EGFR status, PR 24, SD 4, PD 15, ORR 48.0%, DCR 56.0%.There was no significant difference in the mutation rate of exon 19 and 21 between before and after chemotherapy.The mutation status of serum EGFR was correlated with the pathological type of patients （P〈0.02）.The EGFR gene mutation rate was 35.4% （17/48） before chemotherapy and 50% after chemotherapy.The rate of EGFR gene mutation was 55% before and after chemotherapy.ConclusionEctectin is effective in the treatment of advanced lung cancer, and it is effective in lung adenocarcinoma and may lead to the change of serum EGFR gene mutation in lung cancer patients,for the first-line application of patients treated with ectectin hydrochloride should always observe the changes in serum EGFR gene, to avoid blindness in treatment of patients.
作者
许世佳
薛河东
XU Shi-jia XUE He-dong(Department of Laboratory Medicine, Pinghu First People＇s Hospital, Pinghu 314200, China Department of Respiratory Medicine, Pinghu First People＇s Hospital, Pinghu 314200, China)
出处
《中国生化药物杂志》
CAS
2017年第6期292-294,共3页
Chinese Journal of Biochemical Pharmaceutics
