Ann Thorac Surg:EGFR 突变状态影响I期非小细胞肺癌患者的预后

2013-09-05 佚名 丁香园

表皮生长因子激素受体(EGFR)基因突变可以改善晚期非小肺癌(NSCLC)患者的疗效及预后。然而,对于它在早期非小细胞肺癌患者预后中的作用没有得到很好的鉴定。 针对这种情况,来自美国马萨诸塞州总医院和哈佛医学院医学系的Michael Lanuti博士等人进行了一项研究。

表皮生长因子激素受体(EGFR)基因突变可以改善晚期非小肺癌(NSCLC)患者的疗效及预后。然而,对于它在早期非小细胞肺癌患者预后中的作用没有得到很好的鉴定。

针对这种情况,来自美国马萨诸塞州总医院和哈佛医学院医学系的Michael Lanuti博士等人进行了一项研究。研究结果在线发表于2013年8月7日的《胸外科年鉴》(Ann Thorac Surg)杂志上。【原文下载】

作者发现完全切除的I期非小细胞肺癌患者EGFR 突变阳性与EGFR野生型相比有显着的生存优势。

该研究通过对初始治疗完全切除的I期(T 1-2A 0)非小细胞肺癌(2004至2011年)307名患患者以直接测序或多重聚合酶链反应方法检测EGFR的突变状态。采用Kaplan-Meier方法和Cox回归模型比较表皮生长因子受体突变体和野生型患者的复发率,无病生存期,总生存期。

研究结果表明,307名患者被纳入这项研究,其中62例肿瘤有EGFR突变和245例是EGFR 野生型。肿瘤患者伴有EGFR突变与野生型相比复发率显著降低(9.7%vs21.6%,P = 0.03),中位无病生存时间延长(8.8vs7.0年,P = 0.0085),提高整体的5年生存率(98%vs73%,P = 0.003)。肺叶切除术是最常用的治疗方案, 307例中209例采用了该手术方法。在这些患者中,EGFR 突变与较好的整体生存相关(危险比为0.45; 95%的置信区间,0.13?0.83,P = 0.017),估计5年生存率分别为98%和70%。表皮生长因子受体基因突变(P = 0.026),肿瘤大小小于2厘米(P = 0.04)被认为是无病生存时间的独立预后指标,而年龄,性别,吸烟状态不是。

该研究发现,完全切除的I期非小细胞肺癌患者EGFR 突变阳性与EGFR野生型相比有显着的生存优势。表皮生长因子受体基因突变是完全切除的I期非小细胞肺癌一个积极的预后指标。

原文下载

Izar B, Sequist L, Lee M, Muzikansky A, Heist R, Iafrate J, Dias-Santagata D, Mathisen D, Lanuti M.The Impact of EGFR Mutation Status on Outcomes in Patients With Resected Stage I Non-Small Cell Lung Cancers.Ann Thorac Surg. 2013 Sep;96(3):962-8. doi: 10.1016/j.athoracsur.2013.05.091. Epub 2013 Aug 8.


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    2013-12-17 yyj062
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    2013-09-07 liuyiping
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