中国肺癌杂志Issue(11)：804-811,8.DOI:10.3779/j.issn.1009-3419.2014.11.06
EGFR 19和21外显子突变肺癌患者的临床特征比较和预后分析
Clinical Characteristics and Outcomes of Lung Cancer Patients with EGFR Mutations in Exons 19 and 21
摘要
Abstract
Background and objective Studies on the epidermal growth factor receptor (EGFR) signaling pathways and the therapeutic effects of EGFR-tyrosine kinase inhibitors (EGFR-TKIs) have recently proven that targeted therapy has a major role in the treatment of lung cancer. However, the therapeutic effects of EGFR-TKIs on lung cancers with different EGFR mutation subtypes remain unclear. And if there is a signiifcant difference in the effects of EGFR-TKIs, the mechanisms for the difference remain unclear. hTe aim of this study was to investigate the clinical importance of EGFR mutations in exons 19 and 21 of lung cancer patients and to compare the outcomes of these patients. Methods hTe study recruited 113 patients who had non-small cell lung cancer (NSCLC) with EGFR mutations. EGFR mutations were detected for 47 patients using Real-time PCR or DNA sequencinag. hTe mutations of the remaining patients were determined using xTag-EGFR liquid chip technology. All stages I-III patients underwent radical resection followed by 4 cycles of postopera-tive chemotherapy. Patients with pleural metastases underwent pleural biopsy, pleurodesis, and chemotherapy only. Patients with distant metastases underwent biopsy and chemotherapy only. Collected clinical data were analyzed using SPSS 19.0 sotfware. Results EGFR exon mutations 19 and 21 were found in 56 and 57 patients, respectively. hTe mean age of patients with exon 19 mutations was lower than the age of the patients with exon 21 mutations (57.02±11.31 years vs 62.25±7.76 years, respectively;P<0.05). hTe primary tumors of patients with exon 19 mutations were more likely occur in the right lung. hTere were no signiifcant differences in gender, smoking status, histopathology, level of differentiation, and stage of disease (P>0.05) between the patients with exon 19 and 21 mutations;and survival analysis of 91 (80.5%) patients with complete clinical data found no differences in overall survival. Stratiifcation analysis found out that patients with exon 19 mutations had longer overall survival associated with age>61 years, male gender, ever smoking, and stage IV disease;al-though the differences were not signiifcant. Conclusion Compared to the lung cancer patients with EGFR exon 21 muta-tions, the patients with EGFR exon 19 mutations were younger, and their primary tumors were more likely to occur in the right lung. hTere were no signiifcant differences between the lung cancer patients with exon 19 and 21 mutations for overall survival, gender, smoking status, histopathology, level of differentiation, and disease stage.关键词
肺肿瘤/EGFR/靶向治疗/预后Key words
Lung neoplasms/EGFR/Target therapy/Prognosis引用本文复制引用
刘仁旺,刘京豪,李昕,李颖,赵青春,李作生,刘红雨,陈军..EGFR 19和21外显子突变肺癌患者的临床特征比较和预后分析[J].中国肺癌杂志,2014,(11):804-811,8.基金项目
本研究受国家自然科学基金（No.81172233、No.81372306）、天津自然科学基金重点项目和面上项目（No.12JCZDJC24400、No.13JCYBJC22600）、天津市科技支撑重点抗癌重大专项（No.12ZCDZSY16100）的资助This study was partially supported by grants from National Natural Science Foundation of China (No.81172233, No.81372306), Natural Science Foundation of Tianjin (No.12JCZDJC24400, No.13JCYBJC22600), and Tianjin Science and Technology Support Program (All to Jun CHEN)(No.12ZCDZSY16100) （No.81172233, No.81372306）
