晚期非小细胞肺癌患者EGFR基因突变检测状况的回顾性研究

发布时间：2018-04-25 21:46

  本文选题：非小细胞肺癌 + EGFR　； 参考：《吉林大学》2017年硕士论文

【摘要】：背景和目的:肺癌是目前全球范围内发病率和死亡率最高的恶性肿瘤。据报道,2015年我国肺癌患者新增73.33万人,死亡61.02万人,居于榜首。非小细胞肺癌(non-small cell lung cancar,NSCLC)约占原发性肺癌的85%,并且有超过70%的患者在就诊时已属于局部晚期或发生远处转移。分子靶向治疗在晚期非小细胞肺癌的中起到的作用越来越重要。EGFR突变是NSCLC患者中最常见的基因突变类型,目前针对EGFR的治疗是NSCLC治疗中疗效最确切、应用最广泛的驱动基因靶向治疗。很多国际指南都推荐晚期非小细胞肺癌在治疗前先进行EGFR突变检测,在许多国家EGFR突变检测广泛应用并成为临床常规检测项目,以此确保患者在治疗过程中接受最合适的治疗方案。本项研究目的是收集吉林大学第一医院晚期非小细胞肺癌患者EGFR检测现状的数据,包括EGFR送检比例(检测率),分析影响送检EGFR检测的相关因素;分析EGFR突变检测结果与一般临床病理特征之间的关系;统计EGFR突变检测结果。方法:收集2014年1月1日~2015年12月31日期间在吉林大学第一医院住院的首次确诊或术后复发的晚期非小细胞肺癌(ⅢB~Ⅳ期)患者353例。结果应用SPSS21.0进行统计学分析,采用χ2检验或Fisher精确概率法进行各临床特征及人口统计学对EGFR基因突变情况分析。结果:1.353例患者中,178例患者送检EGFR基因突变检测,检测率为50.4%,其中EGFR突变阳性的81例(45.5%)。最常见的为19、21号外显子,突变亚型最多的为21-L858R,共35例(43.2%),其次为19-del,共32例(39.5%)。最常用的EGFR突变检测方法为ARMS法。2.本研究共353例患者,男性组209例,送检患者84例,检测率为40.2%%;女性组144例,送检患者94例,检测率为65.3%%。吸烟指数400组204例,送检患者130例,检测率为63.7%;吸烟指数≥400组149例,送检患者48例,检测率为32.2%。腺癌组249例,送检患者165例,检测率为66.3%;非腺癌组104例,送检患者13例,检测率为12.5%。组织学标本组共266例,送检患者135例,检测率为50.8%;脱落细胞组共66例,送检患者43例,检测率为65.2%;其他无充足样本的共21例,送检患者0例。差异均有统计学意义(P0.05)。3.送检EGFR检测的178例患者,吸烟指数400组130例,突变型65例,突变率为50.0%,吸烟指数≥400组48例,突变型16例,突变率为33.3%;腺癌组165例,突变型79例,突变率为47.9%,非腺癌组13例,突变型2例,突变率为15.4%;M0的患者24例,突变型4例,突变率16.7%;M1的患者154例,突变型77例,突变率50.0%。差异均有统计学意义(P0.05)。结论:1.EGFR基因突变检测的检测率为50.4%,EGFR突变阳性率45.5%。EGFR基因突变检测与病理类型(腺癌)相关,与年龄、性别、吸烟指数、医保类型、标本类型无明显相关性。2.EGFR突变常见于吸烟指数400,腺癌,有远处转移的非小细胞肺癌患者。3.EGFR基因突变主要发生在19、21号外显子。最常用的EGFR突变检测方法为ARMS法。
[Abstract]:Background and objective: lung cancer is one of the most common malignant tumors in the world. According to reports, in 2015, China's lung cancer patients increased by 733300 people, 610200 deaths, ranked first. Non-small cell lung cancer (NSCLC) accounts for 85% of primary lung cancer, and more than 70% of the patients were locally advanced or distant metastases at the time of visit. Molecular targeting therapy plays an increasingly important role in the treatment of advanced non-small cell lung cancer. EGFR mutation is the most common type of gene mutation in patients with NSCLC. At present, the treatment of EGFR is the most effective in the treatment of NSCLC. The most widely used driving gene targeting therapy. Many international guidelines recommend EGFR mutation detection before treatment for advanced non-small cell lung cancer. EGFR mutation detection is widely used in many countries and has become a routine clinical test. This ensures that patients receive the most appropriate treatment during the course of treatment. The purpose of this study was to collect the data of EGFR detection status of patients with advanced non-small cell lung cancer (NSCLC) in the first Hospital of Jilin University, including the proportion of EGFR (detection rate), and analyze the related factors that affect the EGFR detection. The relationship between EGFR mutation detection and general clinicopathological features was analyzed, and the results of EGFR mutation detection were analyzed. Methods: from January 1, 2014 to December 31, 2015, 353 patients with advanced non-small cell lung cancer (stage 鈪，

本文编号：1803114