真实世界中EGFR基因状态对ⅢA(N2)期肺腺癌手术患者生存的影响

Effect of real-world EGFR gene status on survival in operative patients with stageⅢA(N2)lung adenocarcinoma

目的探讨表皮生长因子受体(EGFR)基因状态对ⅢA(N2)期肺腺癌完全手术切除患者生存的影响。方法回顾性分析2010年6月1日至2018年12月31日新疆医科大学附属肿瘤医院收治的113例ⅢA(N2)期肺腺癌手术切除患者生存情况。采用Kaplan-Meier方法进行总生存期(OS)和无病生存期(DFS)的单因素分析,采用Cox比例风险模型进行多因素分析。结果113例患者的中位OS和DFS分别为82、26个月,5年OS率和DFS率分别为55%、24%。多因素分析显示,年龄、术后辅助化疗、EGFR基因状态对OS有影响(P<0.05)。≤60岁较>60岁患者的死亡风险下降了65.0%,未行术后辅助化疗的死亡风险是行术后辅助化疗患者的3.191倍,EGFR基因阳性相较于阴性患者的死亡风险下降了62.9%。多因素分析显示,年龄对DFS有影响(P<0.05)。≤60岁较>60岁患者的DFS风险下降了41.8%。结论应关注EGFR基因状态对ⅢA(N2)期肺腺癌手术切除患者生存的影响。

Objective To investigate the effect of epidermal growth factor receptor(EGFR)gene status on the survival of the patients with stageⅢA(N2)lung adenocarcinoma complete resection.Methods The survival status in 113 patients with stageⅢA(N2)lung adenocarcinoma complete resection in this hospital from June 1,2010 to December 31,2018 was retrospectively analyzed.The Kaplan-Meier method was adopted to conduct the univariate analysis on the overall survival(OS)and disease-free survival(DFS)and the Cox proportional hazard model was adopted to conduct the multivariate analysis.Results Among 113 patients,the median OS and DFS were 82 months and 26 months respectively.The 5-year OS and DFS rate were 55%and 24%,respectively.The multivariate analysis showed that the age,postoperative adjuvant chemotherapy and EGFR gene status had the effect on OS(P<0.05).The death risk in≤60 year old was decreased by 65.0%compared with>60 years old.The death risk in the patients without conducting postoperative adjuvant chemotherapy was 3.191 times of those with postoperative adjuvant chemotherapy.The death risk in the patients with EGFR gene positive was decreased by 62.9%compared with those with gene negative.The multivariate analysis showed that the age had the influence on DFS(P<0.05).The DFS risk in the patients aged≤60 years old was decreased by 41.8%compared with those aged>60 years old.Conclusion Attention should be paid to the effect of EGFR gene status on survival of the patients with stageⅢA(N2)lung adenocarcinoma surgical resection.