脑胶质瘤EGFR基因及对放化疗预后的影响

Expression of epidermal growth factor receptor gene affects the prognosis of post-operative radiation and chemotherapy of glioma patients

目的研究胶质瘤患者表皮生长因子受体(EGFR)基因表达意义及对术后放化疗疗效和预后的影响。方法选取沈阳军区总医院神经外科同一医疗组196例资料完整原发胶质瘤患者资料,统计不同级别胶质瘤EGFR基因表达情况,观察对比术后放化疗患者2年生存率。结果 EGFR突变139例,Ⅰ级组0例,Ⅱ级组62.6%(33/53),Ⅲ级组68.33%(41/60),Ⅳ级组87.83%(65/74),随胶质瘤的级别增高,其阳性率增高;术后2年随访141例患者,放化疗可延长患者生存期,同级别EGFR阳性患者的生存率低于阴性患者,表达率越高放疗敏感性越低、生存期越短,生存率降低。结论胶质瘤细胞恶性度与EGFR表达有密切关系,EGFR基因可作为放化疗敏感性参照指标。

Objective The effect of expression of epidermal growth factor receptor （EGFR） gone on the prognosis of post-operative radiation and chemotherapy in the patients with glioma and its significance were investigated. Methods A total of 196 cases of primary glioma with integrated data in the same medical teams of General Hospital of Shenyang Military Command were collected. The EGFR gene expression of different grades of glioma was counted and the post-operative 2-year survival rate with radiation and chemotherapy was compared. Results There were 139 cases of EGFR mutation including 0 case of Grade I, 62.6% of Grade II （33/53）, 68. 33% of Grade III （41/60）, and 87.83% of Grade IV （65/74）. The positive rate was increased with the increase of glioma maligancy. A total of 141 patients were followed up for 2 years and it suggested that radiation and chemotherapy could prolong the survival period. In the same pathological grade, the patients with positive EGFR expression had lower survival rate compared with those with negative expression. The higher expression rate, the lower the radiation sensitivity, the shorter the survival rate, and the survival difference was statistically significant. Conclusion Malignancy of glioma ceils is closely related with the expression of EGFR, so EGFR gene can be used as an index to radiation and chemotherapy sensitivity.