EGFR基因19或21外显子突变非小细胞肺癌的临床病理特征及靶向治疗效果

Targeted Therapy and Clinicopathological Features of Patients with Non-small Cell Lung Cancer and Exon 19 and 21 Mutations in EGFR Gene

目的探究非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)基因19或21外显子突变情况及临床病理特征,分析其靶向治疗效果。方法选取120例EGFR基因突变阳性NSCLC患者作为研究对象,采用直接测序法对EGFR基因19及21外显子突变状态予以检测,比较患者EGFR基因19及21外显子突变情况及NSCLC临床病理特征。采用随机数字表法将患者进行分组,对照组60例,给予常规治疗;观察组60例,给予靶向治疗。对2组患者临床治疗效果、中位生存期进行综合评价。结果 EGFR基因19外显子突变率61. 7%,显著高于EGFR基因21外显子突变率38. 3%,差异有统计学意义(P <0. 05);患者在性别、年龄、有无吸烟史、临床分期、有无远处转移、有无手术切除史方面差异无统计学意义(P> 0. 05);在淋巴转移、病理类型、组织类型方面的数据比较,差异有统计学意义(P <0. 05)。为期1个月干预治疗结果显示观察组治疗有效率为95. 0%,显著高于对照组的71. 7%,差异有统计学意义(P <0. 05);观察组患者治疗后中位生存期显著高于对照组,差异有统计学意义(P <0. 05)。结论 NSCLC患者具有较高的EGFR基因19外显子突变率,通过对患者EGFR基因19、21外显子突变的检测,能够为临床治疗提供有效的参考。

Objective To explore the mutation and clinicopathological features of epidermal growth factor receptor( EGFR) gene 19 or 21 in non-small cell lung cancer( NSCLC) patients,and to analyze its targeted therapeutic effects. Methods120 patients with EGFR gene mutation-positive NSCLC were selected as subjects. The mutation status of EGFR gene 19 and 21 was detected by direct sequencing. The mutations of exon 19 and 21 and the clinicopathological features of NSCLC were compared. Patients were divided into groups by random number table method,60 cases in the control group,and conventional treatment;60 cases in the observation group were given targeted therapy. The clinical treatment effect and median survival time of the two groups were comprehensively evaluated. Results The mutation rate of exon 19 of EGFR gene was 61. 7%,which was significantly higher than that of exon 21 of EGFR gene( 38. 3%). The difference was statistically significant( P < 0. 05). The exons 19 and 21 of exon mutations were gender and age. There was no significant difference in the history of non-smoking history,clinical stage,presence or absence of distant metastases,and history of surgical resection( P > 0. 05). There was statistically significant difference in lymph node metastasis,pathological type,and histological type,P < 0. 05;The two groups of patients were given 1 month of intervention treatment,the results showed that the observation group treatment efficiency was 95. 0%,significantly higher than the control group of 71. 7%,the difference was statistically significant( P < 0. 05);observation group patients The median survival time after treatment was significantly higher than that of the control group,and the difference was statistically significant( P < 0. 05). Conclusion NSCLC patients have higher mutation rate of exon 19 and exon 21 of EGFR gene. The detection of exon 19 and exon 21 of EGFR gene in patients with NSCLC can provide an effective reference for clinical treatment.