晚期NSCLC患者外周血中EGFR突变预测EGFR TKIs一线治疗的疗效的观察

摘要

Objective : To study EGFR TKIs'therapeutic effect as the first - line therapy by determining the EGFR mutations in advanced NSCLC patients'peripheral blood. Methods : Peripheral blood from 51 patients with advanced NSCLC submitted to EGFR TKI drugs was determined by fluorescence polarization ( TDI - FP ) assay , the relationship between EGFR mutations in peripheral blood and the effectiveness of EGFR TKIs was analyzed. Results : The rate of EGFR mutation determined by TDI - FP in 51 patients' peripheral blood was 60. 8％ ( 31/51 ). After EGFR TKIs the first - line treatment, the overall response rate of mutational and wild type group were 41. 9％ and 5. 0％ , the disease control rate were 77. 4％ and 15. 0％ , and the median progression - free survival were 13. 0 months and 7. 0 months , respectively. Compared with the way of detecting EGFR mutations in tissue, the π of detecting EGFR mutations in peripheral blood by TDI - FP was 84. 2％ . NSCLC patients with EGFR mutations treated hy EGFR TKIs as the first - line therapy achieved much better effectiveness. Conclusion : Determining the mutations of EGFR in advanced NSCLC patients'peripheral blood shows significant value in predicting the outcome of EGFR TKI drugs as the first - line therapy.%目的:检测NSCLC患者外周血EGFR突变情况,预测EGFR TKIs作为治疗晚期NSCLC的一线疗法的疗效.方法:应用荧光偏振(TDI-FP)法检测51例晚期非小细胞肺癌患者外周血EGFR基因突变情况,口服EGFR TKI进行治疗,分析外周血基因突变结果与EGFR TKI疗效之间的关系.结果:TDI-FP法检测出的外周血EGFR突变率为60.8%(31/51).经EGFR TKIs一线治疗后,EGFR突变型和EGFR野生型有效率(RR)分别为41.9%和5.0%;疾病控制率(DCR)分别为77.4%和15.0%;中位PFS则分别为13.0和7.0个月.与检测组织中EGFR突变比较,TDI-FP法检测外周血EGFR突变的正确率(π)为84.2%.统计学分析显示,EGFR突变型NSCLC患者应用EGFR TKIs一线治疗能获得更佳疗效.结论:应用荧光偏振法检测NSCLC患者外周血中的EGFR基因突变,对于预测EGFR TKI作为一线治疗的疗效有重要的价值.