【佳學(xué)基因檢測(cè)】表皮生長(zhǎng)因子受體突變狀態(tài)對(duì) IB-IIIA 期原發(fā)性肺腺癌無(wú)反復(fù)生存的預(yù)后因素

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根據(jù)基因檢測(cè)結(jié)果分析中的基因解碼方法發(fā)現(xiàn)《BMC Cancer》在.?2022 Sep 9;22(1):966.發(fā)表了一篇題目為《表皮生長(zhǎng)因子受體突變狀態(tài)對(duì) IB-IIIA 期原發(fā)性肺腺癌無(wú)反復(fù)生存的預(yù)后因素》腫瘤靶向藥物治療基因檢測(cè)臨床研究文章。該研究由Tetsuya Isaka,?Hiroyuki Ito,?Tomoyuki Yokose,?Haruhiro Saito,?Hiroyuki Adachi,?Kotaro Murakami,?Jun Miura,?Noritake Kikunishi,?Yasushi Rino?等完成。促進(jìn)了腫瘤的正確治療與個(gè)性化用藥的發(fā)展，進(jìn)一步強(qiáng)調(diào)了基因信息檢測(cè)與分析的重要性。

腫瘤靶向藥物及正確治療臨床研究?jī)?nèi)容關(guān)鍵詞：

輔助化療, EGFR突變,病理階段,原發(fā)性肺腺癌,無(wú)反復(fù)生存

腫瘤靶向治療基因檢測(cè)臨床應(yīng)用結(jié)果

背景：具有表皮生長(zhǎng)因子受體 (EGFR) 突變 (Mt) 的病理分期 IB-IIIA 肺腺癌即使在有效切除后也具有高反復(fù)率。然而，關(guān)于 Mt 反復(fù)的危險(xiǎn)因素的報(bào)道很少。本研究旨在分析伴有和不伴有 EGFR 突變的病理分期 IB-IIIA 原發(fā)性肺腺癌患者的無(wú)反復(fù)生存期 (無(wú)反復(fù)生存期) 相關(guān)的臨床病理因素。方法：接受 Mt 治好性手術(shù)的患者 (n = 208)包括 2010 年 1 月至 2020 年 12 月期間攜帶 EGFR 外顯子 21 L858R 點(diǎn)突變或 EGFR 外顯子 19 缺失突變和 EGFR 突變野生型肺腺癌（Wt，n = 358）。接受輔助EGFR-酪氨酸激酶抑制劑的患者被排除在外。使用多變量 Cox 回歸分析分析 無(wú)反復(fù)生存期 的預(yù)后因素。結(jié)果：Mt 組和 Wt 組的 5 年 無(wú)反復(fù)生存期 率分別為 43.5% 和 52.3% (p = 0.907)。 Mt 組 無(wú)反復(fù)生存期 的預(yù)后因素包括吸煙史（風(fēng)險(xiǎn)比 [HR]，1.49；p = 0.049）、血管侵犯（HR，1.84；p = 0.023）和淋巴結(jié)轉(zhuǎn)移（HR，1.96；p = 0.005） ）。然而，輔助化療不是預(yù)后因素（HR，1.02；p = 0.906）。相比之下，正電子發(fā)射斷層掃描 (PET) 賊大標(biāo)準(zhǔn)化攝取值 (SUV) ≥ 6.0 (HR, 1.53; p = 0.042), 淋巴管浸潤(rùn) (HR, 1.54; p = 0.036), 淋巴結(jié)轉(zhuǎn)移 (HR, 1.79; p = 0.002）和輔助化療（HR，0.60；p = 0.008）是 Wt 組 無(wú)反復(fù)生存期 的預(yù)后因素。結(jié)論： IB-IIIA 期原發(fā)性肺腺癌 無(wú)反復(fù)生存期 的預(yù)后因素因表皮生長(zhǎng)因子受體突變狀態(tài)而異。輔助化療對(duì) 無(wú)反復(fù)生存期 的影響也因 EGFR 突變狀態(tài)而異。 EGFR突變；病理階段；原發(fā)性肺腺癌；無(wú)反復(fù)生存。

腫瘤發(fā)生與反復(fù)轉(zhuǎn)移國(guó)際數(shù)據(jù)庫(kù)描述：

Background:?Pathological stage IB-IIIA lung adenocarcinoma with an epidermal growth factor receptor (EGFR) mutation (Mt) has a high recurrence rate even after complete resection. However, there have been few reports on the risk factors for Mt recurrence. This study aimed to analyze the clinicopathological factors related to the relapse-free survival (RFS) of patients with pathological stage IB-IIIA primary lung adenocarcinoma with and without an EGFR mutation.Methods:?Patients who underwent curative surgery for Mt (n = 208) harboring the EGFR exon 21 L858R point mutation or EGFR exon 19 deletion mutation and EGFR mutation wild-type lung adenocarcinoma (Wt, n = 358) between January 2010 and December 2020 were included. Patients who received adjuvant EGFR-tyrosine kinase inhibitors were excluded. The prognostic factors for RFS were analyzed using a multivariable Cox regression analysis.Results:?The 5-year RFS rates in the Mt and Wt groups were 43.5 and 52.3%, respectively (p = 0.907). Prognostic factors for RFS in the Mt group included smoking history (hazard ratio [HR], 1.49; p = 0.049), blood vessel invasion (HR, 1.84; p = 0.023), and lymph node metastasis (HR, 1.96; p = 0.005). However, adjuvant chemotherapy was not a prognostic factor (HR, 1.02; p = 0.906). In contrast, positron emission tomography (PET) max standardized uptake value (SUV) ≥ 6.0 (HR, 1.53; p = 0.042), lymphatic vessel invasion (HR, 1.54; p = 0.036), lymph node metastasis (HR, 1.79; p = 0.002), and adjuvant chemotherapy (HR, 0.60; p = 0.008) were prognostic factors for RFS in the Wt group.Conclusions:?Prognostic factors for RFS in stage IB-IIIA primary lung adenocarcinoma differ by epidermal growth factor receptor mutation status. The impact of adjuvant chemotherapy on RFS also differed by EGFR mutation status.Keywords:?Adjuvant chemotherapy; EGFR mutation; Pathological stage; Primary lung adenocarcinoma; Relapse-free survival.