非小细胞肺癌表皮生长因子受体基因突变的异质性

Heterogeneity of EGFR mutations in non-small cell lung cancer

表皮生长因子受体（EGFR）酪氨酸激酶抑制剂（TKIs）在EGFR基因活化突变阳性晚期非小细胞肺癌（NSCLC）患者中疗效显著，然而，同样是EGFR活化突变阳性的NSCLC患者接受EGFR-TKIs治疗后，疗效仍有明显差异；同一个患者的不同瘤灶也会对EGFR-TKIs出现不同的反应，这些现象可能与EGFR基因突变异质性有关，同一瘤灶的不同部分、同一患者的不同瘤灶、以及同一瘤灶治疗前后EGFR突变状态都有可能不一致。本文将从这三个方面对EGFR突变异质性研究进展作一综述。

Although EGFR-TKIs have been shown to be highly effective in patients with positive EGFR mutations, the response of these patients who receive EGFR-TKIs therapy is extremely different. Discrepancy of the response exists in different lesions of the same individual. Thees phenomena might be associated with the heterogeneity of EGFR mutations, which involves intratumoral and intertumoral heterogeneity and gene heterogeneity before and after therapy. The review will introduce advance of EGFR heterogeneity from these three aspects.