性别与非小细胞肺癌患者吉非替尼疗效之间的关系

目的探讨非小细胞肺癌患者EGFR基因突变及吉非替尼疗效的男女差异。方法收集从2002年至2005年期间在广东省人民医院接受手术的135例非小细胞肺癌患者的肿瘤标本,立即置于液氮中,然后保存于-80℃,采用Trizol法提取组织DNA后,巢式PCR扩增EGFR基因的18、19、21外显子,纯化PCR产物后,对DNA的正义链和反义链进行测序,结合患者的临床资料以及服用吉非替尼患者的疗效进行分析。结果135例患者中EGFR基因突变的患者有29例（21．5％）,男性和女性的突变率分别为19．1％和26．8％（P=0．364）;20例接受吉非替尼治疗的患者中男性和女性疾病控制率分别为76．9％（10／13）和100％（7／7）（P=0．521）,男性和女性中位疾病进展时间差异无统计学意义（分别为9个月和14个月,P=1）。结论对于非小细胞肺癌患者,性别与EGFR突变以及吉非替尼治疗的疗效和预后之间无明显关系。

Relationship of the curative effects of gefitinib on non-small cell lung carcinoma to gender and to epithelial growth factor receptor status

OBJECTIVE: To investigate the mutation of epithelial growth factor receptor (EGFR) gene in the non-small cell lung carcinoma (LSCLG) patients with different genders and the relationship between the gender of LSCLG patients and the curative effects of gefitinib, an specific tyrosine kinase. METHODS: Tumor specimens were obtained from 135 NSCLC patients, 94 males (78.7% smoking) and 41 females (17.1% smoking), of which 20 received gefitinib treatment after the failure of chemotherapy, during operation and stored at -80 degrees C. The genomic DNA of the cancer tissues was extracted by using Trizol reagent. Nest-PCR was used to amplify the exons 18, 19, and 21 of the EGFR gene and the PCR products were purified by agarose electrophoresis and then sequenced. RESULTS: EGFR mutation was found in 29 of the 135 NSCLC patients (21.5%), with a mutation rate of 19.1% in the males and a mutation rate of 26.8% in the females (P = 0.344). The mutation types included G719C and G719V in exon 16, delE746 - 750, and delE746 - 751 in exon 19, and L858R and L861Qin exon 21. Among the 20 patients who received gefitinib treatment the disease control rate was 85% (17/20), being 76.9% in the male patients (10/13) and being 100% in the female patients (7/7) (P = 0.521). There were not significant differences in the mean time-to-progression (TTP) between the male and female patients (9 months vs. 14 months, P = 1), and between the patients with the wild type of EGFR gene and those with the mutated type of gene (9 months vs. 14 months, P = 1). CONCLUSION: There is no significant relationship between the curative effect of gefitinib on NSCLC and gender and EFGR status.