老年非小细胞肺癌患者血浆表皮生长因子受体突变状况的分析

Analysis of mutation status of plasma epidermal growth factor receptor in elderly patients with non-small cell lung cancer

目的探讨老年非小细胞肺癌(NSCLC)患者血浆循环肿瘤脱氧核糖核酸(ctDNA)表皮生长因子受体(EGFR)突变状况与各临床参数的相关性。方法收集2016年6月—2020年3月在复旦大学附属华东医院就诊的84例老年NSCLC患者的血浆样本,抽提ctDNA后采用超级突变扩增阻滞系统方法检测EGFR突变,分析各临床参数组ctDNA浓度、EGFR突变率和突变状况的差异。结果老年NSCLC患者的ctDNA浓度为7.70(4.85,10.90)ng/L,因年龄与疾病状态而存在差异(P<0.05)。EGFR突变率为54.76%,与靶向治疗史有相关性(P=0.002);EGFR突变状况与患者的吸烟史(P=0.046)、靶向治疗史(P=0.023)和疾病状态(P=0.016)相关。EGFR 20号外显子的错义突变T790M在接受靶向治疗组及疾病进展组的突变率更高。结论老年NSCLC患者血浆ctDNA EGFR突变状况与年龄、吸烟史、靶向治疗史及疾病状态相关。

Objective To investigate the correlation between plasma circulating tumor deoxyribonucleic acid(ctDNA)epidermal growth factor receptor(EGFR)mutation status and clinical parameters in elderly patients with non-small cell lung cancer(NSCLC).Methods Plasma samples of 84 elderly patients with NSCLC were collected from June 2016 to March 2020 in our hospital.After ctDNA was extracted,EGFR mutation was detected by super amplification refractory mutation system method.The differences of ctDNA concentration,EGFR mutation rate and status among different clinical characteristic groups were analyzed.Results The ctDNAconcentration of elderly patientswithNSCLCwas 7.70(4.85,10.90)ng/L,which varied with age and disease status(P<0.05).The mutation rate of EGFR was 54.76%,which was related to the history of targeted therapy(P=0.002).EGFR mutation status was related to the patients'smoking history(P=0.046),targeted therapy history(P=0.023)and disease status(P=0.016).Themissense mutation T790Min exon 20 of EGFR had highermutation rate in targeted therapy group and disease progression group.Conclusion Plasma ctDNA EGFR mutation status in elderly NSCLC patients is related to age,smoking history,targeted therapy history and disease status.