【摘要】 目的 分析非小细胞肺癌表皮生长因子受体(EGFR)基因突变情况，并探讨血浆EGFR基因突变状态对吉非替尼治疗效果及预后的影响。方法 选取2017年1月—2019年6月收治的非小细胞肺癌135例，收集患者治疗前肿瘤组织及血浆标本，检测血浆及肿瘤组织EGFR基因状态。根据EGFR基因是否突变以及突变丰度将40例EGFR敏感型非小细胞肺癌患者分为EGFR基因突变低丰度组22例和EGFR基因突变高丰度组18例，分析EGFR基因突变丰度与EGFR敏感型非小细胞肺癌患者经吉非替尼治疗效果的相关性，采用Kaplan-Meier生存曲线分析EGFR基因突变丰度对EGFR敏感型非小细胞肺癌患者预后的影响。通过Cox回归分析判断EGFR敏感型非小细胞肺癌患者吉非替尼治疗预后影响因素。结果 135例肿瘤组织EGFR基因突变率为34.8%,血浆EGFR基因突变率为29.6%,二者检测结果高度一致(P<0.01)。EGFR基因突变高丰度组疗效优于低丰度组(P<0.01);EGFR基因突变高丰度组总生存时间长于低丰度组(P<0.05)。EGFR基因突变高丰度是EGFR敏感型非小细胞肺癌患者吉非替尼治疗预后不良的保护因素(P<0.01)。结论 血浆EGFR基因突变丰度与EGFR敏感型非小细胞肺癌吉非替尼临床疗效及预后密切相关，可作为预测EGFR敏感型非小细胞肺癌吉非替尼治疗获益的有效手段。更多还原

【Abstract】 Objective To investigate the epidermal growth factor receptor(EGFR) gene mutation in non-small cell lung cancer(NSCLC), and to analyze the effect of plasma EGFR gene mutation status on the efficacy of Gefitinib and prognosis. Methods A total of 135 patients with NSCLC who were treated from January 2017 to June 2019 were selected. Tumor tissue and plasma samples were collected before treatment, and the EGFR gene status of plasma and tumor tissue DNA was detected. According to EGFR gene mutation and mutation abundance, 40 patients with EGFR-sensitive NSCLC were divided into a low-abundance EGFR gene mutation group(n=22) and a high-abundance EGFR gene mutation group(n=18). The correlation between EGFR gene mutation abundance and efficacy of Gefitinib in the treatment of patients with EGFR-sensitive NSCLC was analyzed. Kaplan-Meier survival curve was used to analyze the influence of EGFR gene mutation abundance on the prognosis of patients with EGFR-sensitive NSCLC. The prognostic factors of Gefitinib treatment in patients with EGFR-sensitive NSCLC were identified by COX regression analysis. Results The mutation rate of EGFR gene in 135 tumor tissues was 34.8%, which was highly consistent with that in plasma(29.6%)(P<0.01). The efficacy of the high-abundance EGFR gene mutation group was better than that of the low-abundance group(P<0.01), and the median OS time of the high-abundance EGFR gene mutation group was longer than that of the low-abundance group(P<0.05). The high abundance of EGFR gene mutation was a protective factor for poor prognosis in patients with EGFR-sensitive NSCLC treated with Gefitinib(P<0.01). Conclusion Plasma EGFR gene mutation abundance is closely related to the clinical efficacy and prognosis of Gefitinib in EGFR-sensitive NSCLC. Therefore, it can be used as an effective means to predict the benefit of Gefitinib therapy in EGFR-sensitive NSCLC.更多还原