晚期老年非小细胞肺癌患者外周血中泛素连接酶和髓样细胞白血病基因-1的表达与使用埃克替尼预后初探

To study the correlation of peripheral blood F-box and WD repeat domain-containing domain protein7 and myeloid cell leukemia-1 expression levels with the prognosis of Icotinib administration in elderly patients with advanced non-small-cell lung cancer

目的 研究晚期非小细胞肺癌（NSCLC）老年患者外周血中泛素连接酶（FBW7）和髓样细胞白血病基因-1（MCL-1）的表达水平与使用埃克替尼预后的相关性. 方法 选择76例60岁以上的表皮生长因子受体（EGFR）突变敏感并且接受埃克替尼靶向治疗的晚期NSCLC老年患者,采用实时荧光定量PCR（RT-QPCR）检测每位患者外周血中FBW7和MCL-1基因表达水平,对两者的表达与临床病理因素、患者的总生存期（OS）、无进展生存期（PFS）相关性进行统计分析. 结果 FBW7和MCL-1的表达呈负相关（r=-0.37,P＜0.001）.外周血中FBW7高表达、MCL-1低表达的患者可以获得更高的有效率（P＜0.001）,更长的总生存期和无进展生存期.Cox回归分析发现外周血中FBW7和MCL-1的表达水平是影响OS和PFS的独立因素. 结论 FBW7高表达、MCl-1低表达的NSCLC患者更能从埃克替尼靶向治疗中获益,两者可作为埃克替尼疗效预判的指标,为临床埃克替尼应用提供支持和参考.

Objective To study the correlation of the prognosis of Icotinib administration with the expression levels of F-box and WD repeat domain-containing 7（FBW7） and myeloid cell leukemia-1 （MCL-1） in peripheral blood in elderly patients with advanced non-small-cell lung cancer.Methods A total of 76 patients aged 60 years or over diagnosed with non-small-cell lung cancer（NSCLC） with EGFR-sensitive mutations and under Icotinib treatment were enrolled in this study.FBW7 and MCL-1 mRNA expression levels in peripheral blood were detected by real-time quantitative PCR（RT-QPCR）.The correlation of FBW7 and MCL-1 expression levels with clinical and histological parameters,overall survival （OS）,and progression-free-survival （PFS） was analyzed.Results The FBW7 expression level and the MCL-1 expression level were negative correlated（r =-0.37,P 〈0.001）.High FBW7 expression levels and low MCL-1 expression levels in peripheral blood were associated with improved therapeutic efficacy of Icotinib （P〈0.001） and extended OS and PFS.Cox regression analysis showed that the expression levels of FBW7 and MCL-1 in peripheral blood were independent influencing factors for OS and PFS.Conclusions Patients with high FBW7 expression levels and low MCl-1 expression levels are more likely to benefit from Icotinib treatment.Expression levels for either factor can be used as a predictive indicator for the effectiveness of Icotinib and provide guidance for its clinical use.