肺腺癌患者EGFR、ALK基因突变与预后的关系

Relationship between EGFR and ALK gene mutations with prognosis in patients with lung adenocarcinoma

目的分析肺腺癌患者表皮生长因子受体(EGFR)、间变性淋巴瘤激酶(ALK)基因突变与预后的关系。方法回顾性分析2017年1月至2020年12月于该院实施手术切除肺腺癌的200例患者,随访至2022年12月,其中失访94例。收集患者临床资料,根据患者2年内肺腺癌复发、转移情况将其分为预后良好组(80例,肺腺癌未复发转移)与预后不良组(26例,肺腺癌复发转移),检测所有患者EGFR、ALK基因,比较两组肺腺癌患者基线资料以及EGFR、ALK基因突变情况,应用COX回归分析患者预后的影响因素,比较不同EGFR、ALK基因突变情况患者无瘤生存率。结果两组年龄构成、吸烟情况、病理类型、病理分期、EGFR及ALK基因突变情况比较,差异均有统计学意义(P<0.05),而性别、术式比较,差异无统计学意义(P>0.05)。COX回归分析显示,肺腺癌患者年龄、吸烟情况、病理类型、病理分期、EGFR、ALK基因突变为预后的影响因素(P<0.05)。EGFR基因突变阳性患者无瘤生存率显著高于阴性患者(P<0.05)。ALK基因突变阳性患者无瘤生存率显著高于阴性患者(P<0.05)。结论肺腺癌患者预后情况与患者年龄、吸烟情况、病理类型、病理分期、EGFR及ALK基因突变情况密切相关,对肺腺癌患者实施靶向治疗有利于改善预后。

Objective To analyze the relationship between epidermal growth factor receptor(EGFR)and anaplastic lymphoma kinase(ALK)gene mutations with the prognosis in the patients with lung adenocarcinoma.Methods A retrospective analysis was performed on 200 patients with lung adenocarcinoma implementing surgical resection in this hospital from January 2017 to December 2020 and the patients were followed up until December 2022.Among them,94 cases lost to follow-up.The clinical data of the patients were collected.According to the recurrence and metastasis situation of lung adenocarcinoma within 2 years,the patients were divided into the good prognosis group(80 cases,no recurrence and metastasis of lung adenocarcinoma)and poor prognosis group(26 cases,recurrence and metastasis of lung adenocarcinoma).The EGFR and ALK gene of all patients was detected.The general data and gene mutations of EGFR and ALK were compared between the two groups.The COX regression was used to analyze the influencing factors of prognosis of the patients,and the tumor-free survival rates were compared among the patients with different EGFR and ALK gene mutations.Results There were statistically significant differences in the proportion of age,smoking status,pathological type,pathological stage,EGFR and ALK gene mutation between the two groups(P<0.05),while there was no statistically significant difference in the gender and surgical methods(P>0.05).The COX regression analysis showed that the age,smoking status,pathological type,pathological stage,EGFR and ALK gene mutation of the patients with lung adenocarcinoma were influence factors for prognosis(P<0.05).The tumor-free survival rate of the patients with EGFR gene mutation positive was significantly higher than that of the patients with EGFR gene mutation negative(P<0.05).The tumor-free survival rate of the patients with ALK gene mutation positive was significantly higher than that of the patients with ALK gene mutation negative(P<0.05).Conclusion The prognosis of the patients with lung adenocarcinoma is closely related to their age,smoking status,pathological type,pathological stage,EGFR and ALK gene mutation.Implementing the targeted therapy in the patients with lung adenocarcinoma is beneficial to improve the prognosis.