中晚期肺腺癌获得性表皮生长因子受体T790M突变的相关性分析

Correlation analysis of acquired EGFR T790M mutations in intermediate and advanced lung adenocarcinoma

目的分析中晚期肺腺癌获得性T790M突变与一般临床特征的相关性。方法回顾性分析2010年1月至2020年9月福建医科大学附属协和医学院收治并确诊为肺癌的119例患者的临床资料,收集患者临床资料,采用单因素及多因素Logistic分析表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗后发生T790M突变的危险因素。结果119例EGRF-TKI治疗的患者中61例(51%)发生T790M突变,58例(49%)未发生T790M突变。所有患者中位无进展生存期(PFS)为(14.2±1.2)个月。两组性别、年龄、吸烟史、高血压、2型糖尿病、脑转移、骨转移、T分期、M分期、治疗方案比较差异比较无统计学意义;两组N分期、靶向治疗方案比较差异有统计学意义(P<0.05)。Logistic多因素分析结果显示,N0-1与埃克替尼治疗是影响EGFR-TKI治疗后发生T790M突变的危险因素(P<0.05)。结论对于中晚期肺腺癌患者,经过EGFR-TKI治疗后,N0-1及埃克替尼治疗是发生T790M突变的危险因素。

Objective To analyze the correlation between acquired T790M mutation and general clinical features in advanced lung adenocarcinoma.Methods The clinical data of 119 patients diagnosed with lung cancer admitted to Union Medical College Affiliated to Fujian Medical University from January 2010 to September 2020 were retrospectively analyzed,the clinical data of patients were collected,and the risk factors of T790M mutation after epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)treatment were analyzed by univariate and multivariate Logistic analysis.Results Total of 119 patients treated with EGRF-TKI,61(51%)had T790M mutations and 58(49%)did not.The median progression free surviva(PFS)for all patients was(14.2±1.2)months.There was no significant difference in gender,age,smoking history,hypertension,type 2 diabetes,brain metastases,bone metastases,T stage,M stage and treatment plan between the two groups;there were significant differences in n stage and targeted therapy between the two groups(P<0.05).Logistic multivariate analysis showed that N0-1 and ectinib treatment were risk factors for T790M mutation after EGFR-TKI treatment(P<0.05).Conclusion N0-1 and ectinib therapy are risk factors for T790M mutation in patients with advanced lung adenocarcinoma after EGFR-TKI treatment.