基因检测指导Ⅱ、ⅢA期非小细胞肺癌术后辅助化疗的临床研究

目的 探讨以基因检测为指导的非小细胞肺癌 （NSCLC） 术后个体化治疗的效果。方法 将接受全胸腔镜肺癌根治术的Ⅱ、 ⅢA 期 NSCLC 患者 56 例随机分为个体化治疗组 26 例和非个体化治疗组 30 例， 取个体化治疗组患者新鲜肿瘤组织进行基因检测， 检测靶标包括切除修复交叉互补复合体 1(ERCC1)、 核苷酸还原酶亚单位 1 (RRM1)、 β微管蛋白Ⅲ、 胸苷酸合成酶(TS)、 表皮生长因子受体(EGFR)、 乳腺癌敏感蛋白 1 （BRCA1） 等。个体化治疗组根据检测结果制定化疗方案， 非个体化治疗组采用 “吉西他滨+顺铂” 方案， 比较 2 组 1 年、 2 年无疾病生存率 （DFS）、疾病无进展生存期(PFS)和总生存期(OS)。结果 个体化治疗组 2 年 DFS （57.69%）、 PFS （月： 22.1±5.0） 和 OS （月： 24.1±3.2） 均高于非个体化治疗组 （分别是 30.00%、 18.9±6.2、 21.9±4.3， 均 P < 0.05）； 2 组 1 年 DFS （88.46% vs 83.33%）差异无统计学意义。结论 基于基因检测的个体化治疗可以提高 NSCLC 术后的 2 年 DFS、 PFS 和 OS， 提高化疗的有效率。

Clinical study of postoperative individualized chemotherapy based on genetic testing results for non-small cell lung cancer

Objective To explore the efficiency of postoperative individualized chemotherapy based on genetic testing results for non-small cell lung cancer (NSCLC). Methods Fifty-six NSCLC patients at stageⅡor ⅢA who accepted video- assisted thoracic operation were divided into two groups: the individualized chemotherapy group (n=26) and non individual⁃ ized chemotherapy group (n=30). The fresh lung tumor tissue of individualized chemotherapy group was tested target gene， in⁃ cluding excision repair cross complementing 1 (ERCC1)， ribonucleotide reductase subunit M1 (RRM1)， β-tubulin Ⅲ， thymi⁃ dylate synthase （TS)， epidermal growth factor receptor (EGFR) and breast cancer gene 1 (BRCA1). The theraputic plan was based on genetic testing results in individualized chemotherapy group, and the non individualized chemotherapy group re⁃ ceiving gemcitabine plus cisplatin. The 1-year disease free survival (DFS), 2-year disease free survival (DFS), the progres⁃ sion- free survival (PFS) and the overall survival (OS) were compared between two groups. Results The 2- year DFS (57.69%), PFS (22.1±5.0 months) and OS (24.1±3.2 months) were significantly higher in the individualized chemotherapy group than those of non individualized chemotherapy group (respectively 30.00%, 18.9±6.2 months, 21.9±4.3 months, P < 0.05). There was no significant difference in 1-year DFS between two groups (88.46% vs 83.33%, P < 0.05). Conclusion The individualized chemotherapy based on genetic testing results can enhance the 2-year DFS, PFS, OS and the efficiency of postoperative adjuvant chemotherapy for NSCLC.