表皮生长因子受体基因突变对非小细胞肺癌患者肿瘤生长、转移及生存率的影响

目的 探讨表皮生长因子受体(EGFR)基因突变对非小细胞肺癌(NSCLC)患者预后的影响.方法 收集厦门大学附属中山医院2005年12月至2009年8月107例NSCLC患者的手术切除癌组织标本,采用PCR扩增和基因测序方法检测EGFR外显子18～21突变,分析基因突变对患者肿瘤生长、转移及生存率的影响.结果 107例患者中检出EGFR基因突变者30例(28.0%),其中外显子18突变1例,外显子19突变8例,外显子21突变20例,外显子18和19多重(3个)突变1例.EGFR基因突变患者肿瘤生长速度的M(Q1～3)为0.42(0.17-1.04)mm/d,明显快于基因正常患者0.21(0.19～1.00)mm/d,P<0.05];淋巴结转移发生率和肺外器官转移发生率与基因正常患者比较差异无统计学意义(P>0.05).EGFR基因突变和基因正常患者术后平均生存时间分别为(18.2±8.9)和(25.5±7.8)个月,1、2、3年生存率分别为62.2%、47.7%、46.9%和72.2%、57.3%、56.3%,Log-rank检验显示两者间生存情况差异无统计学意义(X2=0.59,P>0.05).结论 EGFR基因突变可以促进NSCLC生长,但不是影响预后的因素.

Influence of mutations in epidermal growth factor receptor gene on growth, metastasis and survival rate of non-small cell lung carcinoma

Objective To evaluate the influence of mutations in epidermal growth factor receptor (EGFR) gene on the prognosis of non-small cell lung cancer (NSCLC). Methods A total of 107 NSCLC patients undergoing tumor resection from December 2005 to August 2009 at our hospital were recruited.Mutations of exons 18-21 of EGFR gene in patients were detected by polymerase chain reaction (PCR) amplification and gene sequencing. The influence of mutations in EGFR gene on the growth, metastasis and survival rate of NSCLC was evaluated. Results EGFR mutations were detected in 30 (28. 0% ) of 107 patients. The mutation distribution was as follows: exon 18(n=1),exon 19(n=8),exon 21(n=20),and exons 18 and 19 multiple(triple mutations,n=1).NSCLC with EGFR mutations had a higher growth velocity than that without EGFR mutationsM(Q1-3):0.42(0.17-1.04)mm/d vs 0.21(0.19-1.00)mm/d.P<0.05].EGFR mutations had no significant impaction on neither the lymph node metastasis of NSCLC(P>0.05)nor on the tumor metastasis to other organs(P>0.05).The mean survival time of patients with and without EGFR mutations were(18.2±8.9)and(25.5±7.8)months respectively.The 1.2 and 3-year survival rate were 62.2%vs 72.2%.47.7% vs 57.3%and 46.9%vs 56.3%respectively between patients with and without EGFR mutations.Log-rank test didn't show a significant difference among them(X2=0.59,P>0.05).Conclusiom The EGFR mutations promote the growth of NSCLC.But it may not be a factor of predieting prognosis.