EGFR蛋白表达状态对KRAS野生型晚期结直肠癌患者的预后分析

Differentiation on Suspected Complex Syndrome

目的探讨EGFR蛋白表达对KRAS野生型晚期肠癌（meRe）患者总生存时间（OS）的影响。方法：纳入KRAS野生型mCRC患者158例。采用免疫组织化学法检测EGFR蛋白，随访患者年龄、性别、病理分级、体能状态（ECOG-PS）、治疗基线情况和生存时间等资料。结果：158例患者中位OS为16．0个月，EGFR高表达者38．096（60／158）0单因素分析显示，0S与ECOGPS、EGFR蛋白状态、是否使用西妥昔单抗相关（P〈0．05）。亚组分析显示，标准化疗＋西妥昔单抗组，EGFR高表达者中位OS明显延长（P=0．002）；标准化疗组，EGFR蛋白表达情况对OS无影响（P=0．616）。COX生存模型显示，ECOGPS、是否使用西妥昔单抗、EGFR／使用西妥昔单抗交汇均是影响OS的独立预后因素（P〈0．05）。结论：体能状态良好、使用西妥昔单抗治疗是KRAS野生型的晚期结直肠癌患者预后良好的独立因素，同时，EGFR蛋白水平高表达可能是KRAs野生型的晚期结直肠癌患者使用西妥昔单抗治疗的疗效预测指标。

Objective To investigate the effect of EGFR protein expression on the total survival time （OS） in patients with KRAS wildtype advanced colorectal cancer （mCRC）. Methods：Included in KRAS wild type mCRC patients in 158 cases. EGFR protein was detected＇ by immunohistochemical method, and the age, sex,.pathological grade, physical condition （PS ECOG）, treatment baseline and survival time were followed up. Results： the median OSwas 16 months in 158 patients, and EGFR was highly expressed in 38% （60/158）. Single factor analysis showed that OS was associated with PS ECOG, EGFR protein status, and the use of P〈0.05.Subgroup analysis showed that OS was significantly longer （P=0.002） in the patients with high expression of EGFR in the standard chemotherapy plus West rituximab group, and the EGFR protein expression had no effect on OS （P=0.616） in the standard chemotherapy group. COX survival model showed that PS ECOG, whether the use of West rituximab, EGFR/in the use of rituximab in the convergence of OS is an independent prognostic factor （P〈0.05）.Conclusion： Good physical condition, the use of cetuximab is KRAS wild-type metastatic colorectal cancer patients have a good prognosis independent factors.At the same time,level of EGFR protein high expression may be late KRAS wild-type nodes in patients with rectal cancer using index in predicting the efficacy of cetuximab treatment.