二代测序法用于非小细胞肺癌突变基因检测的经济学评价

Economic Evaluation on the Next-Generation Sequencing for the Detection of Mutant Genes in Non-Small Cell Lung Cancer

目的:分析与传统基因检测技术相比,二代测序法用于非小细胞肺癌突变基因检测的经济性。方法:对国际二代测序法用于非小细胞肺癌的经济学评价进行系统综述。从卫生体系视角出发,构建决策树模型,测算二代测序法(8基因突变联合检测)对比荧光实时定量PCR法(3基因突变联合检测)的成本-效果,并进行敏感性分析。结果:纳入4篇研究,其中2篇研究认为与传统基因检测技术相比,二代测序法用于非小细胞肺癌的突变基因检测具有一定的经济性,但仍需要结合具体情况进一步研究。模型研究结果表明,对比荧光实时定量PCR法(3基因突变联合检测),采用二代测序法(8基因突变联合检测),非小细胞肺癌患者多存活1年所需要增加的诊断成本为97501.18元,以3倍人均GDP为阈值时,具有成本-效果。结论:二代测序法用于非小细胞肺癌突变基因检测具有一定经济性,但未来仍需要更新数据和结果。

Objective:To analyze the economy of next-generation sequencing(NGS)for non-small cell lung cancer mutation gene detection compared with traditional gene detection technology.Methods:First,a systematic review was conducted on the eco⁃nomic evaluation of international NGS methods for non-small cell lung cancer.Secondly,from the perspective of the health system,the research builds a decision tree model to calculate incremental cost-effectiveness of the NGS method(joint detection of 8-gene mu⁃tations)versus the fluorescent real-time quantitative PCR(qPCR)method(joint detection of 3-gene mutations).Results:4 studies were included,of which 2 studies believed that compared with traditional gene detection technology,NGS method for mutation gene detection of non-small cell lung cancer is economical,but still needs to be combined further research on the domestic situation.The results of the model study show that,compared with the qPCR,the NGS brings additional diagnostic cost for patients with non-small cell lung cancer to survive for 1 year is 97501.18 yuan.It has cost-effectiveness when the threshold value is 3 times per capita GDP.Conclusion:The NGS method is economical for the detection of mutant genes in non-small cell lung cancer,but the data and results still need to be updated in the future.