200例肺腺癌脑转移患者驱动基因突变情况及预后关系

朱中山; 严文辉; 李小兵; 杨洲; 白鹏

200例肺腺癌脑转移患者驱动基因突变情况及预后关系

1. 湖南省第二人民医院肿瘤科
2. 昆明医科大学第一附属医院神经微创外科

基金项目:

基金：湖南省卫计委科研计划基金资助项目 (B2013087);

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出版历程
- 收稿日期: 2018-06-13

Driver Genes Mutation and Survival Analysis in 200 Patients with Pulmonary Adenocarcinoma Brain Metastasis

Funds:

基金：湖南省卫计委科研计划基金资助项目 (B2013087);

摘要

摘要: 目的探讨肺腺癌脑转移患者驱动基因突变情况及预后关系.方法选取湖南省第二人民院2013年1月至2015年12月来就诊经病理确诊为肺腺癌脑转移患者200例, 检测EGFR、KRAS、ALK、Her-2的基因突变情况, 分析EGFR基因突变与患者临床病理及预后的关系.结果 EGFR、KRAS、ALK、Her-2的基因突变率分别为48.5%、5.5%、6.5%、3.5%.EGFR基因突变在性别、年龄、BMI、分化程度等方面比较, 差异有统计学意义 (P<0.05) ;而在吸烟方面比较, 差异无统计学意义 (P>0.05) .EGFR基因突变接受靶向治疗的患者生存时间长于未接受靶向治疗的患者 (28.0±4.5) 月vs (11.2±1.4) 月;经Log Rank (Mantel-Cox) 统计学分析, 2组中位生存时间差异有统计学意义 (P<0.05) .结论肺腺癌脑转移患者驱动基因EGFR突变有较高的突变率, 应用靶向治疗可明显延长生存时间.
- 肺腺癌 /
- 脑转移 /
- 靶向治疗 /
- 驱动基因
Abstract: Objective To investigate the relationship between the driver genes mutation and the survival in patients with pulmonary adenocarcinoma brain metastasis. Methods We enrolled 200 patients with pulmonary adenocarcinoma brain metastasis confirmed histologically from Jan 2013 to Dec 2015, and tested EGFR, KRAS, ALK, Her-2 gene mutation, analyzed the relationship between EGFR gene mutation and clinicopathological data and prognosis of the patients.Results The mutation rates of EGFR, KRAS, ALK and Her-2 gene mutation were 48.5%, 5.5%, 6.5%, 3.5%, respectively. Compared with EGFR gene mutation patients, the sex, age, BMI, differentiation were significant different (P<0.05) , however, the smoking was not significant different (P>0.05) . Patients with EGFR gene mutation who received targeted therapy survived longer than who did not receive targeted therapy, (28.0 ±4.5) months vs (11.2 ±1.4) months. By Log Rank (Mantel-Cox) , the median survival time between the two groups was statistically significant (P<0.05) .Conclusions The mutation rate of EGFR gene mutation was high in patients with pulmonary adenocarcinoma brain metastasis, and the patients will survivel longer by targeted therapy.
- Pulmonary adenocarcinoma /
- Brain metastasis /
- Targeted therapy /
- Driver gene

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参考文献(21)

[1]	[1]FERLAY J S I.Incidence/Mortality Data.GLOBOCAN2012 v1.0, Cancer Incidence and Mortality Worldwide:IARC Cancer Base No.11[Internet].International Agency for Research on Cancer, Lyon, France, 2013.Available from URL:http://globocan.iarc.fr.
[2]	[2]GLOBOCAN 2012:Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012[EB/OL].http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx, 2013-12-12.
[3]陈万青, 张思维, 曾红梅, 等.中国2010年恶性肿瘤发病与死亡[J].中国肿瘤, 2014, 23 (1) :1-10.
[4]石岳泉, 杨向红.非小细胞肺癌的驱动基因及其临床意义[J].中国肺癌杂志, 2014, 17 (6) :481-486.
[5]	[5]SHI Y, AU J S, THONGPRASERT S, et al.A prospective, molecular epidemiology study of EGFR mutations in Asian patients with advanced non-small-cell lung cancer of adenocarcinoma histology (PIONEER) [J].J Thorac Oncol, 2014, 9 (2) :154-162.
[6]	[6]LI H, PAN Y, LI Y, et al.Frequency of well-identified oncogenic driver mutations in lung adenocarcinoma of smokers varies with histological subtypes and graduated smoking dose[J].Lung Cancer, 2013, 79 (1) :8-13.
[7]	[7]KIM H R, KIM D J, KANG D R, et al.Fibroblast growth factor receptor 1 gene amplification is associated with poor survival and cigarette smoking dosage in patients with resected squamous cell lung cancer[J].J Clin Oncol, 2013, 31 (6) :731-737.
[8]	[8]LINDEMAN N I, CAGLE P T, BEASLEY M B, et al.Molecular testing guideline for selection of lung cancer patients for EGFR and ALK tyrosine kinase inhibitors:guideline from the college of american pathologists, international association for the study of lung cancer, and association for molecular pathology[J].J Thorac Oncol, 2013, 8 (7) :823-859.
[9]	[9]ROSELL R, CARCERENY E, GERVAIS R, et al.Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation positive non small cell lung cancer (EURTAC) :a multicentre, open label, randomised phase3 trial[J].Lancet Oncol, 2012, 13 (3) :239-246.
[10]张娜, 王文彤, 陶遵威.非小细胞肺癌分子靶向治疗的最新研究进展[J].天津药学, 2015, 27 (1) :44-46.
[11]	[11]COSTA C, MOLINA M A, DROZDOWSKYJ A, et al.The impact of EGFR T790M mutations and BIM m RNA expression on outcome in patients with EGFR-mutant NSCLC treated with erlotinib or chemotherapy in the randomized phase III EURTAC trial[J].Clin Cancer Res, 2014, 20 (7) :2001-2010.
[12]	[12]GAZDAR A F.EGFR mutations in lung cancer:Different frequencies for different folks[J].J Thorac Oncol, 2014, 9 (2) :139-140.
[13]	[13]NAKAMURA R, INAGE Y, TOBITA R, et al.Epidermal growth factor receptor mutations:effect on volume doubling time of non-small-cell lung cancer patients[J].J Thorac Oncol, 2014, 29 (9) :1294-1304.
[14]	[14]XU Z, HANG J, HU J, et al.Gefitinib, an EGFR tyrosine kinase inhibitor, activates autophagy through AMPK in human lung cancer cells[J].J Buon, 2014, 19 (2) :466-473.
[15]赵建国, 徐农.非小细胞肺癌的分子分型[J].实用肿瘤杂志, 2014, 29 (5) :399-403.
[16]	[16]LI Y, LI Y, YANG T, et al.Clinical significance of EML4-ALK fusion gene and association with EGFR and KRAS genemutations in 208 Chinese patients with nonsmall cell lung cancer[J].Plos One, 2013, 8 (1) :e52093.
[17]	[17]KRIS M G, JOHNSON B E, BERRY L D, et al.Using multiplexed assays of oncogenic drivers in lung cancers to select targeted drugs[J].Jama, 2014, 311 (19) :1998-2006.
[18]王辉, 王英浩, 陈晓英.放射治疗联合厄洛替尼对肺腺癌脑转移的疗效分析[J].中国医药导刊, 2016, 18 (2) :137-139.
[19]张帆.EGFR-TKIs联合全脑放疗与全脑放疗治疗肺腺癌脑转移疗效分析[J].中国医学工程, 2014, 22 (12) :71-72.
[20]陈雪琴, 杨邵瑜, 黄杰, 等.肺腺癌患者驱动基因表达及生存分析[J].实用肿瘤杂志, 2016, 31 (3) :246-269.
[21]周荻, 徐欣, 谢华英, 等.全脑放疗联合靶向治疗与同步放、化疗治疗非小细胞肺癌脑转移疗效分析[J].上海交通大学学报 (医学版) , 2013, 33 (4) :480-484.

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