血浆EGFR基因突变检测在晚期非小细胞肺癌患者EGFR-TKI疗效评估中的价值

发布时间：2018-02-10 14:33

本文关键词： 非小细胞肺癌扩增阻滞突变系统表皮生长因子受体循环肿瘤DNA　出处：《山东医药》2017年13期 　论文类型：期刊论文

【摘要】：目的探讨血浆表皮生长因子受体(EGFR)突变状态检测在晚期非小细胞肺癌患者表皮生长因子受体酪氨酸酶抑制剂(EGFR-TKI)疗效评估中的价值。方法应用扩增阻滞突变系统(ARMS)法检测70例晚期非小细胞肺癌患者肿瘤组织及血浆的EGFR突变状态。以肿瘤组织中的EGFR突变状态检测为对照,计算血浆中EGFR突变状态检测的敏感性、特异性、一致性,并比较两种检测对患者EGFR-TKI疗效及预后评估的差异。结果以配对的肿瘤组织EGFR突变检测结果为对照,ARMS法检测血浆EGFR突变的敏感性、一致性及特异性分别为58.1%、72.9%、96.3%。在38例经过EGFR-TKI治疗的患者中,肿瘤组织EGFR突变型患者的有效率及中位无进展生存期均优于EGFR野生型患者(有效率:69%比11.1%,P=0.005;无进展生存期:10个月比3个月,P=0.003)。血浆EGFR突变型患者与肿瘤组织EGFR突变型患者的有效率及中位无进展生存期均相似(有效率:P=0.908;中位无进展生存期:P=0.593)。在血浆标本中,EGFR突变型患者的中位无进展生存期长于EGFR野生型患者(10个月比7个月,P=0.032)。EGFR突变型患者的有效率高于EGFR野生型患者,但差异无统计学意义(70.6%比42.9%,P=0.111)。结论血浆EGFR突变可预测晚期非小细胞肺癌患者EGFR-TKI疗效,但因较高的假阴性率,血浆EGFR野生型患者需应用肿瘤组织进一步检测。
[Abstract]:Objective to evaluate the value of EGFR mutation in evaluating the efficacy of EGFR-TKI, an inhibitor of epidermal growth factor receptor tyrosinase (TKI) in patients with advanced non-small cell lung cancer (NSCLC). Methods Amplification Block mutation system (ARMS) was used to evaluate the efficacy of EGFR in patients with advanced non-small cell lung cancer (NSCLC). Methods the EGFR mutation status in tumor tissues and plasma of 70 patients with advanced non-small cell lung cancer was detected, and the EGFR mutation status in tumor tissues was measured as control. The sensitivity, specificity, consistency of EGFR mutation status in plasma were calculated. Results the results of EGFR mutation in matched tumor tissues were compared with the results of EGFR mutation in plasma, and the sensitivity of EGFR mutation in plasma was compared. The consistency and specificity were 58.1% and 72.9%, respectively. In 38 patients treated with EGFR-TKI, The effective rate and median progression-free survival of patients with EGFR mutation in tumor tissue were higher than those of wild-type patients with EGFR (effective rate:: 69% vs 11.1%, P < 0.005; progression-free survival: 10 months vs 3 months; P 0.003). Plasma EGFR mutation and EGFR mutation in tumor tissues. The effective rate and median progression-free survival were similar (effective rate: 0. 908; median progression free survival: 0. 593). The median progression-free survival in plasma samples was longer than that in EGFR wild-type patients (10 months vs 7 months). The response rate of variant patients was higher than that of wild-type patients with EGFR. But there was no significant difference between 70.6% and 42.9%. Conclusion Plasma EGFR mutation can predict the efficacy of EGFR-TKI in patients with advanced non-small cell lung cancer. However, because of the high false negative rate, the wild-type plasma EGFR should be further detected by tumor tissue analysis.
【作者单位】：广东省佛山市第一人民医院;
【基金】：广东省科技计划项目(20120318077) 佛山市科技创新专项基金(2014AG10003) 佛山市医学类科技攻关项目(2014AB00307)
【分类号】：R734.2

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