胶质母细胞瘤中EGFRv Ⅲ表达及对预后的影响

Prognostic effect of epidermal growth factor receptor variant Ⅲ in glioblastoma

目的探讨表皮生长因子突变受体Ⅲ（epidermal growth factor receptor variantⅢ,EGFRvⅢ）在胶质母细胞瘤（glioblastoma,GB）中表达,研究影响患者预后的因素。方法收集2012-01至2013-12的98例GB患者,通过免疫组化染色观察EGFRvⅢ在组织标本中表达情况,以性别、年龄、肿瘤体积、生长部位及卡氏评分（Karnofsky Perfomance Scale,KPS）等临床参数作为研究因素进行统计学分析。结果 （1）免疫组化结果显示,EGFRvⅢ阳性表达率在GB病理标本和正常脑组织中分别为38.8%和0%。（2）单因素分析结果显示：EGFRvⅢ阳性组与阴性组中年龄、KPS评分差异有统计学意义（χ2=7.018,P=0.008;χ2=12.101,P=0.001）。（3）GB患者生存分析结果显示：EGFRvⅢ阴性组与阳性组的中位生存时间分别为13个月（95%CI,8.99~17.01）和12个月（95%CI,9.81~14.18）;在生存时间大于12个月患者中,EGFRvⅢ阴性组和阳性组的中位总生存时间分别为22个月（95%CI,16.91~27.09）和16个月（95%CI,14.04~17.95）;≥60岁和〈60岁两组,中位总生存时间分别为10个月（95%CI,6.73~13.27）和15个月（95%CI,11.90~18.10）。（4）Cox多因素分析KPS、EGFRvⅢ阳性表达是影响预后的独立相关因素。结论 EGFRvⅢ阳性表达、年龄和KPS评分是影响GB患者预后的危险因素。

Objective To investigate the influence of epidermal growth factor receptor variant Ⅲ（EGFRv Ⅲ） expression on the prognosis of patients with glioblastoma. Methods A total of 98 patients with glioblastoma were enrolled into this study from January 2012 to December 2015. The expression levels of EGFRv Ⅲ were detected by immunohistochemistry and analyzed their association with clinical parameters such as gender, age, tumor size, growth site and Karnofsky Performance Scale（KPS）, etc. Results（1） The positive rate of EGFRv Ⅲ was 38.8% in 98 cases of patients but 0% in the normal.（2） Single factor analysis showed that age, KPS were statistically significantly different between EGFRv Ⅲ positive and negative groups（χ2=7.018, P=0.008; χ2=12.101, P=0.001）.（3） Survival analysis results showed that median survival time was 13 months（95%CI, 8.99-17.01） in EGFRv Ⅲ negative group and 12 months（95%CI, 9.81-14.18） in EGFRv Ⅲ positive group; the median total survival time over 12 months was 22 months（95%CI, 16.91-27.09） in EGFRv Ⅲ negative group and 16 months（95%CI, 14.04-17.95） in EGFRv Ⅲ positive group; the median total survival time was 10 months（95%CI,6.73-13.27） in patients over 60 years old and 15 months（95%CI, 11.90-18.10） in patients under 60 years old.（4） Cox multiple factors analysis showed that KPS and positive expression of EGFRv Ⅲ were independent correlative factor of disease prognosis. Conclusions Positive expression of EGFRv Ⅲ, age and KPS are the risk factors influencing the prognosis of patients with glioblastoma.