Objective To explore the effect of epidermal growth factor receptor (EGFR) gene mutation on clinical pathology of non-small cell lung cancer (NSCLC) and clinical efficacy of tyrosine kinase inhibitor (TKI) treatment. Methods 460 NSCLC patients who were treated in our hospital from January 2017 to December 2017 were selected in this study. Based on types of mutations, they were divided into mutant positive group (129 cases) and mutant negative group (331 cases). The mutant positive group was further divided into TKI target treatment group (72 cases) and chemotherapy group (57 cases). All patients in the mutant negative group received chemotherapy (331 cases) treatment. Finally, the relationship between the EGFR gene mutation and clinical pathology was analyzed, and the progression-free survival (PFS) among groups of TKI therapy, chemotherapy of mutant positive group and chemotherapy of mutant negative group was compared. Results (1) It was found that the mutation of EGFR gene in NSCLC patients was closely related to the sex, smoking, pathological type, degree of differentiation, and serum carcinoembryonic antigen (CEA) level (P < 0.05). (2) The ORR and DCR in patients treated with TKI were significantly higher than those in other patients with positive gene mutation (P < 0.05). (3) The ORR and DCR in the EGFR mutant negative group were significantly higher than those in the EGFR mutant positive group (P < 0.05). (4) The PFS were significantly different among all groups (P<0.05) : (201.65±20.81) d in TKI group; (116.53 ± 11.61) d in chemotherapy of mutant positive group and (167.59 ± 11.46) d in mutant negative group. Conclusions The mutation of EGFR gene in NSCLC patients occurs more frequently in women, nonsmokers, adenocarcinoma, and those whose serum CEA ≥ 5 ng/mL.TKI therapy can effectively prolong the PFS in patients with EGFR positive mutation. However, it's more effective to use chemotherapy for patients without EGFR positive mutation.%目的 探究表皮生长因子受体 (EGFR) 基因突变对非小细胞肺癌 (NSCLC) 临床病理及酪氨酸激酶抑制剂 (TKI) 临床疗效的影响.方法 选取2017年1-12月于我院进行治疗的460例NSCLC患者为研究对象, 按照其是否出现EGFR基因突变将其区分为突变阳性组 (129例) 与突变阴性组 (331例) , 突变阳性组患者中区分为TKI组 (72例) 与化疗组 (57例) , 突变阴性组患者均接受化疗 (331例) , 分析EGFR基因突变与患者临床病理之间的关系, 对比突变组TKI治疗、突变组化疗及非突变组化疗无进展生存期 (PFS) .结果 (1) 分析发现, NSCLC患者EGFR基因突变与患者性别、吸烟、病理类型、分化程度、血清癌胚抗原 (CEA) 水平均具有密切相关性 (P <0.05) . (2) EGFR基因突变阳性患者中TKI组客观缓解率 (ORR) 及疾病控制率 (DCR) 均高于基因突变阳性患者中化疗组, 对比差异具有统计学意义 (P <0.05) . (3) EGFR突变阴性组患者化疗ORR及DCR均高于EGFR阳性患者中化疗组, 对比差异具有统计学意义 (P <0.05) . (4) EGFR突变患者中TKI组PFS为 (201.65±20.81) d, 突变化疗组PFS为 (116.53±11.61) d, 未突变化疗组PFS为 (167.59±11.46) d, 组间对比差异具有统计学意义 (P <0.05) .结论 EGFR基因突变多发于女性、非吸烟、腺癌、血清CEA≥5 ng/mL的NSCLC患者中, 出现EGFR突变患者采取TKI治疗能有效延长其PFS, 但对无EGFR突变患者采取化疗的方式效果更佳.
展开▼
