非小细胞肺癌EGFR基因突变与脑转移特点的关系

发布时间：2018-04-10 00:03

本文选题：EGFR突变　切入点：非小细胞肺癌　出处：《浙江大学》2017年硕士论文

【摘要】：目的探索非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)的突变状态与各临床特征之间的关系,并且比较不同EGFR突变状态的脑转移患者的影像学特点。方法回顾分析从2012年10月至2016年3月浙江大学医学院附属第二医院收诊的具有EGFR基因突变检测结果的非小细胞肺癌患者。分析比较不同EGFR突变状态患者的临床特征(包括年龄、性别、吸烟史、饮酒史、病理类型、TNM分期等)及脑转移的影像学特点。结果EGFR 突变阳性患者以女性(76%vs37.8%,p0.001),腺癌(60%vs17.2%,p0.001),不吸烟者(69.1%vs35.1%,p0.001),不饮酒者(61.4%vs44.1%,p0.001)多见。低分化癌患者的EGFR突变率较其他分化程度患者低(p=0.001)。进一步分析发现19号外显子突变的患者不管是初发脑转移率(23.6%vs12.1%,p=0.003)还是最终脑转移率(30.7%vs17.0%,p=0.002)都较野生型患者高,而肾上腺转移率则较野生型低(2.9%vs8.6%,p=0.043)。同时分析脑转移患者的影像学特点,不同EGFR突变状态患者在脑转移病灶的数量及最大转移病灶的大小上无显著性差异。结论女性、腺癌、不吸烟、不饮酒患者EGFR突变阳性率更高。19号外显子突变患者发生脑转移的风险较高,发生肾上腺转移的风险较低。另外,19号突变、21号突变及野生型NSCLC脑转移患者在脑转移病灶数量和最大转移灶的大小上不存在显著性差异。
[Abstract]:Objective to investigate the relationship between the mutation status of epidermal growth factor receptor (EGFR) and its clinical features in patients with non-small cell lung cancer (NSCLC), and to compare the imaging features of patients with brain metastasis with different EGFR mutations.Methods from October 2012 to March 2016, non-small cell lung cancer (NSCLC) patients with EGFR gene mutation in the second affiliated Hospital of Zhejiang University Medical College were retrospectively analyzed.To analyze and compare the clinical features (including age, sex, smoking history, drinking history, pathological type and stage of EGFR) and the imaging features of brain metastasis in patients with different EGFR mutation status.Results in the patients with positive EGFR mutation, the number of female patients with EGFR mutation was 77.8 vs 37.8cm, and that of adenocarcinoma was 69.1vs35.1and 61.4vs44.1p0.001respectively, and that of adenocarcinoma was 69.1vs35.1and 61.4vs44.1 / p0.001respectively, which was more common in the patients with adenocarcinoma (vs17.2) and non-smokers (P 0.001) than in the patients with EGFR mutation positivity (n = 61.4 vs 44.1a, P 0.001).The mutation rate of EGFR in patients with poorly differentiated carcinoma was lower than that in patients with other types of differentiation.Further analysis showed that both the primary brain metastasis rate (23.6vs12.1kW) and the final brain metastasis rate (30.7vs17.0cm) of exon 19 mutation patients were higher than those of wild type patients, while the adrenal metastasis rate was lower than that of wild type patients (2.9vs8.6p0.043).At the same time, the imaging features of patients with brain metastasis were analyzed. There was no significant difference in the number of brain metastases and the size of the largest metastatic lesions in patients with different EGFR mutation status.Conclusion the positive rate of EGFR mutation in women, adenocarcinoma, non-smoking and non-drinking patients is higher. The risk of brain metastasis is higher in exon 19 mutation patients, and the risk of adrenal metastasis is lower in patients with exon 19 mutation.In addition, there was no significant difference in the number of brain metastases and the size of the largest metastatic foci in patients with brain metastases of 19 mutation, 21 mutation and wild-type NSCLC.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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