FGFR4基因状态与晚期非小细胞肺癌患者临床病理特征及预后的关系

目的:研究FGFR4基因与晚期非小细胞肺癌（non-small cell lung cancer，NSCLC）患者临床病理特征及预后的关系。方法:采用高通量测序技术筛选肿瘤标本中的FGFR4基因突变状态。通过卡方检验分析FGFR4基因突变状态与临床病理特征的相关性。用Logistic分析其疗效。用Kaplan-Meier曲线和COX模型评估患者生存。结果:在163例晚期非小细胞肺癌患者中FGFR4基因突变患者共有48例（29.4%）。FGFR4基因突变状态与患者的性别、年龄、吸烟史、病理类型、ECOG评分、T分期、是否有淋巴结转移、EGFR及ALK基因状态无明显相关性（P>0.05）。FGFR4野生型患者的一线疗效明显优于突变型的患者（突变型vs野生型，P<0.001），FGFR4野生型患者的疾病控制率（DCR）达68.6%。生存分析显示，突变型患者的中位OS和中位PFS短于野生型的患者（中位OS:16个月vs 43个月，P<0.001；中位PFS:8个月vs 14个月，P<0.001）。多因素结果显示，ECOG 2~3分（HR=2.353，95%CI:1.259~4.398，P=0.007）、有淋巴结转移（HR=3.754，95%CI:2.310~6.101，P＜0.001）、FGFR4基因突变（HR=2.517，95%CI:1.521~4.165，P＜0.001）是影响患者生存的独立危险因素。结论:FGFR4基因影响晚期非小细胞肺癌的预后，野生型患者的生存时间明显长于突变型患者。

The relationship between FGFR4 gene status and clinicopathological features and prognosis in patients with advanced non-small cell lung cancer

Objective:To investigate the relationship between FGFR4 gene and clinicopathological characteristics and prognosis in patients with advanced non-small cell lung cancer(NSCLC).Methods:FGFR4 gene mutations in tumor specimens were screened by high-throughput sequencing.The correlation between FGFR4 mutation status and clinicopathological features was analyzed by chi-square test.Logistic analysis was used to analyze the efficacy.Patients' survival was assessed using Kaplan-Meier curves and COX models.Results:A total of 48(29.4%） patients with FGFR4 gene mutations were found in 163 patients with advanced non-small cell lung cancer.There was no significant correlation between FGFR4 gene mutation status and gender，age，smoking history，pathological type，ECOG score，T stage，lymph node metastasis，EGFR and ALK gene status in patients with advanced non-small cell lung cancer(P>0.05).The first-line efficacy of FGFR4 wild-type patients was significantly better than that of mutant patients(mutant vs wild-type，P<0.001)，and the disease control rate of FGFR4 wild-type patients was 68.6%.Survival analysis showed that the median OS and median PFS of mutant patients were shorter than those of wild-type patients(median OS:16 months vs 43 months，P<0.001；median PFS:8 months vs 14 months，P<0.001).Multivariate results showed that ECOG with 2~3 points (HR=2.353，95%CI:1.259~4.398，P=0.007)，lymph node metastasis(HR=3.754，95%CI:2.310~6.101，P＜0.001)，FGFR4 gene mutations(HR=2.517，95%CI:1.521~4.165，P＜0.001） were independent risk factors affecting patient survival.Conclusion:FGFR4 gene affects the prognosis of advanced NSCLC，and survival time in wild-type patients was significantly longer than that in mutant patients.