山东医药2017，Vol.57Issue(13)：17-19,3.DOI:10.3969/j.issn.1002-266X.2017.13.005
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
Predictive value of EGFR mutation detection in plasma for the EGFR-TKI efficacy in advanced non-small-cell lung cancer patients
摘要
Abstract
To investigate the predictive value of epidermal growth factor receptor (EGFR) mutation detection in plasma for the EGFR tyrosine kinase inhibitor (EGFR-TKI) efficacy in advanced non-small-cell lung cancer (NSCLC) patients.Methods EGFR mutations in the tumor tissues and matched plasma samples from 70 advanced NSCLC patients were assessed using amplification refractory mutation system (ARMS).The sensitivity, specificity and consistency of EGFR mutations in plasma were calculated by taking the EGFR mutations in tumor tissues as the control group.The differences of EGFR-TKI efficacy and prognosis were compared between the two detections.Results Compared with the EGFR mutation detection in the matched tumor tissues, the sensitivity, consistency and specificity of EGFR mutations in plasma detected by ARMS was 58.1%, 72.9% and 96.3%, respectively.For the 38 patients treated with EGFR-TKI, the response rate (ORR) and median progression-free survival (PFS) was significantly superior in the EGFR mutant group as compared with the wild-type group in tumor tissue samples (ORR: 69% vs.11.1%, P=0.005;PFS: 10 months vs.3 months, P=0.003).ORR and PFS of patients with EGFR mutation in plasma was consistent to that of patients with EGFR mutation in tumor tissues (ORR: P=0.908;PFS: P=0.593).In the plasma samples, PFS of patients with EGFR mutations was longer than that without EGFR mutations (10 months vs 7 months, P=0.032).Patients with EGFR mutations had significantly higher ORR than those without mutations (70.6% vs 42.9%, P=0.111).Conclusions The detection of EGFR mutations in plasma can predict the efficacy of EGFR-TKI.However, due to the high false negative rate in plasma samples, for the patients with wild-type EGFR in plasma, they need further confirmation in tumor tissues.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DNAKey words
non-small-cell lung cancer/amplification refractory mutation system/epidermal growth factor receptor/circulating tumor DNA分类
医药卫生引用本文复制引用
冯卫能,张华,陈泽程,唐溢聪,梁剑苗,邓燕明..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[J].山东医药,2017,57(13):17-19,3.基金项目
广东省科技计划项目(20120318077) （20120318077）
佛山市科技创新专项基金(2014AG10003) （2014AG10003）
佛山市医学类科技攻关项目(2014AB00307). （2014AB00307）
