非小细胞肺癌患者中EGFR与TTF-1表达及与患者预后关系的研究

Research of relation between TTF-1 and EGFR mutations and prognosis in NSCLC

目的探索NSCLC患者TTF-1与EGFR突变表达情况及其与患者预后的关系。方法共收集2011.1-2014.12我科NSCLC患者240例组织标本,采用免疫组化法检测TTF-1表达,采用PCR扩增直接测序法检测EGFR突变,采用χ~2检验研究EGFR突变与TTF-1阳性表达的相关性,Kaplan-Meier法分析患者总生存期(OS)与TTF-1及EGFR突变的关系,绘制出生存曲线,P<0.05为有显著统计学意义。结果 TTF-1阳性与患者性别,吸烟指数,病理分型,TNM分期,EGFR突变及PS评分有明显相关性,TTF-1阳性、EGFR突变阳性患者与阴性患者生存曲线均无交叉,生存期有差别,尤其EGFR突变中21外显子阳性患者其生存期明显好(P<0.001)。结论 TTF-1可作为NSCLC患者预测预后的一个独立指标,联合EGFR突变可以更好的预测预后,指导临床诊疗。

Objective To explore the relationship between the expression of TTF-1, EGFR mutations and the prognosis of patients of NSCLC. Methods 240 cases of tissue samples of NSCLC were collected from 2011.1 to 2014.12. Immunohistoehemical staining method was used to detect the TTF-1 expression, and direct sequencing detection was used to detect EGFR mutations. Chi-square test was used to compare the correlation of EGFR mutation positive expression and TTF-1 expression, and Kaplan Meier survival analysis method to analyze the correlation be- tween the patients＇ overall survival （OS） and EGFR mutation and TTF-1. Results The positive expression of TTF-1 had significant relevance with gender, smoking index, pathological type, TNM stage, EGFR mutations and PS score. Through the survival analysis it showed that the prognosis of TTF-1 in patients with positive and EGFR mutation positive was significant difference from negative patients. Their survival curves were without cross, and further a- nalysis of EGFR mutation in exon 21 positive patients showed the survival was obviously better （P 〈 0. 001 ）. Conclusion TTF-1 can be used as an independent predictor to predict prognosis in NSCLC. Further, EGFR mutations can better predict the prognosis of NSCLC patients and guide clinical diagnosis and treatment.