摘要
目的:分析非小细胞肺癌(NSCLC)患者浅表淋巴结EGFR基因突变状态及其采用EGFR-TKI治疗的效果。方法:选取经病理确诊为NSCLC转移浅表淋巴结及部分配对肿瘤原发灶石蜡组织标本行EGFR基因检测,分析临床病理资料,比较部分病例浅表淋巴结转移灶与肿瘤原发灶EGFR基因突变状态差异。此外,根据检测结果分组,比较各组的PFS,并采用COX回归分析了解PFS的影响因素。结果:56例浅表淋巴结行EGFR检测,35例EGFR突变阳性与EGFR野生型21例。无吸烟、腺癌与EGFR突变相关,而女性突变率高于男性,但差异无统计学意义(P>0.05)。11例淋巴结与配对肿瘤原发灶一致性分析,两者一致率为81.8%,Kappa值为0.645,P值为0.020。35例EGFR突变阳性者采用EGFR-TKI治疗,其PFS优于21例采用化疗的EGFR野生型组。COX多因素回归显示,校正腺癌、PS评分,EGFR突变阳性者有利于延长PFS。结论:非小细胞肺癌浅表转移淋巴结EGFR突变检测可用于指导EGFR-TKI的使用。
Objective Analysis of EGFR gene mutation status in superficial lymph nodes of NSCLC patien ts and its therapeutic effect with EGFR-TKI.Method Pathologically confirmed superficial lymph nodes with NSCLC metastasis and paraffin tissue specimens of some primary tumors were examined for EGFR gene.The clinical and pathological data were analyzed and the differences of EGFR gene mutation between superficial lymph node metastases and primary tumors in some cases were compared.In addition,according to the test results,the PFS of each group was compared,and the influencing factors of PFS were analyzed by COX regression.Results 56 cases of superficial lymph nodes underwen t EGFR detection,35 cases of EGFR mutation and 21 cases of EGFR wild type.Non-smoking and adenocarcinoma were associated with EGFR mutation,while the mutation rate in women was higher than that in men,but there was no significant difference(P>0.05).The consistency between lymph nodes and matched primary tumors was 81.8%,Kappa value was 0.645 and P value was 0.020.35 cases of EGFR mutation positive were treated with EGFR-TKI,and their PFS was better than 21 cases of EGFR wild type group treated with chemotherapy.COX multivariate regression showed that correction of adenocarcinoma,PS score and EGFR mutation were beneficial to PFS extension.Conclusion The EGFR gene status of superficial metastasis lymph node can be a good guidance for NSCLC patients treated by EGFR-TKI.
作者
吴晓岚
蔡志明
杨维群
WU Xiao-lan;CAI Zhi-ming;YANG Wei-qun(Departmentof Basic Medical Sciences,Quanzhou Medical College,Quanzhou 362000,China;Department of respiration,Quanzhou first Hospital affiliated to Fujian Medical University,Quanzhou 362000,China)
出处
《吉林医学》
CAS
2019年第6期1173-1177,共5页
Jilin Medical Journal
基金
泉州市科技计划重点项目[项目编号:2014Z34]
