39例肺肉瘤样癌患者的临床病理及分子生物学特点分析

Clinical characteristics and molecular characteristics of 39 cases of pulmonary sarcomatoid carcinoma

目的了解肺肉瘤样癌(pulmonary sarcomatoid carcinoma,PSC)疾病特征以及分子生物学特点,为改善PSC患者预后,寻找可能的靶向药物及位点提供线索。方法回顾性分析2007-2016年39例PSC患者相关临床资料,利用二代基因测序技术检测PSC组织标本的癌症相关基因,分析肉瘤样癌患者的临床病理及分子生物学特点。结果PSC患者中位生存时间为7.5个月,2年生存率为30%,多因素分析结果表明性别、年龄和是否治疗影响患者的总生存期(P<0.05);共18人次检测出基因突变,突变率为46.15%,其中4例(10.25%)检出表皮生长因子受体(EGFR)基因突变,5例(12.82%)检出鼠类肉瘤病毒癌基因(KRAS)突变,2例(5.13%)检出PIK3CA基因突变,8例(20.51%)检出间质表皮转化因子(MET)基因突变,患者是否基因突变与总生存时间差异无统计学意义(P>0.05)。结论PSC患者预后差,性别、年龄及是否治疗对患者总生存时间产生影响,PSC患者基因突变率高。

Objective To understand the characteristics of pulmonary sarcomatoid carcinoma(PSC)and its molecular biological characteristics,and to provide clues for improving the prognosis of patients and searching for possible targeted drugs and sites.MethodsThe clinical data of 39 patients with PSC from 2007 to 2016 were retrospectively analyzed.The second-generation gene sequencing technology was used to detect cancer-related genes in PSC tissue samples.ResultsThe median survival time of PSC patients was 7.5 months,and the two-year survival rate was 30%.Multivariate analysis showed that gender,age,and treatment affected patients′overall survival(P<0.05).A total of 18 mutations were detected,and the mutation rate was 46.15%,in which 4(10.25%)were detected as EGFR receptor gene mutation,5(12.82%)were KRAS gene mutation,2(5.13%)were PIK3CA gene mutation,and 8(20.51%)were MET gene mutation.And there was no statistical relationship between the gene mutation and the overall survival period(P>0.05).ConclusionThe prognosis of patients with PSC is poor.Gender,age and treatment have effects on the overall survival time of the patients,and the mutation rate of PSC patients are high.