BIM基因多态性对晚期肺腺癌一线EGFR-TKIs疗效影响回顾性研究

发布时间：2018-06-10 15:02

本文选题：肺肿瘤 + 酪氨酸激酶抑制剂　；参考：《中国肺癌杂志》2017年08期

【摘要】：背景与目的通过对85例肺腺癌患者石蜡包埋标本及部分全血样本BIM缺失多态性的检测,分析BIM多态性与酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)药物疗效相关性,初探不同类型标本BIM检测的相关性。方法收集2013年2月-2014年11月间经宣武医院胸外科诊断明确的IIIb期-IV期肺腺癌患者,表皮生长因子受体(epidermal growth factor receptor,EGFR)19或21外显子突变85例,给予一线TKIs治疗,采用石蜡组织标本和部分全血进行BIM基因多态性检测,分析两组患者治疗客观有效率(objective response rate,ORR)、无进展生存期(progression-free survival,PFS),并根据吸烟、性别、EGFR突变位点等因素进行单因素分析,同时对比石蜡标本与血液检测BIM的相关性。结果在受检的85例FFPE样本中,BIM基因具有缺失多态性14例(16.47%),纯和无缺失多态性71例(83.53%)。在13例对照样本中,石蜡样本和血液样本检出BIM基因缺失多态性2例,且为相同患者样本。BIM多态性的患者在用药物后的客观缓解率与无多态性组无统计学差异(P0.05)。BIM基因缺失多态性、纯和无缺失患者接受药物治疗的中位PFS分别为7.1个月、12.8个月,存在统计学差异(P=0.013)。男性和女性中位PFS(10.7个月、12.1个月,P=0.835)、吸烟组和非吸烟组中位PFS(9.7个月、12.1个月,P=0.974)、EGFR 19和21外显子中位PFS(8.7个月、12.2个月,P=0.303)比较均无统计学差异(P0.05)。结论检测患者BIM基因多态性对晚期肺腺癌EGFR-TKIs治疗患者的评估预后可能有一定参考意义,但需要进行大样本的研究。
[Abstract]:Background & objective to investigate the association between BIM-deletion polymorphism and tyrosine kinase inhibitors (TKIsa) in 85 paraffin-embedded lung adenocarcinoma patients and some whole blood samples. To explore the correlation of BIM detection in different types of specimens. Methods 85 patients with stage IIIb stage IV lung adenocarcinoma diagnosed by thoracic surgery in Xuanwu Hospital from February 2013 to November 2014 were enrolled in this study. 85 cases of epidermal growth factor receptor EGFRN 19 or 21 exon mutation were treated with first-line TKIs. The BIM gene polymorphism was detected in paraffin tissue samples and partial whole blood. The objective effective rate of two groups was analyzed. The progressive free survival (PFSs) of the two groups were analyzed according to smoking, sex and EGFR mutation sites. At the same time, the correlation between paraffin and blood BIM was compared. Results among 85 FFPE samples, 14 had deletion polymorphism of BIM gene (16.47%) and 71 cases had pure or no deletion polymorphism (83.53%). BIM gene deletion polymorphism was detected in 2 cases in paraffin and blood samples. There was no significant difference in the objective remission rate between the patients with BIM polymorphism and those without drug use. The median PFS of pure and non-deletion patients were 7.1 months and 12.8 months, respectively. There was a statistical difference between P0. 013 and P0. 013. There was no statistical difference between male and female median PFSN 10.7 months (12.1 months), smoking group (9.7 months) and non-smoking group (12.1 months). Conclusion Detection of BIM gene polymorphism in patients with advanced lung adenocarcinoma may be helpful in evaluating prognosis of patients with advanced lung adenocarcinoma, but large sample study is needed.
【作者单位】：首都医科大学宣武医院胸外科首都医科大学肺癌诊疗中心;
【基金】：国家重点基础研究发展计划——中国人类蛋白质组草图(No.2014CBA02004)资助~~
【分类号】：R734.2

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