肺癌驱动基因与非小细胞肺癌生存关系的相关性研究

目的探讨非小细胞肺癌驱动基因EGFR、KRAS、BRAF、PIK3CA、ALK、MET、HER-2、RET、ROS-1与患者预后相关性,寻找更有效防治分子靶标。方法利用Kaplan-Meier(KM)plotter在线数据库分析EGFR、KRAS、BRAF、PIK3CA、ALK、MET、HER-2、RET、ROS-1表达与非小细胞肺癌患者总生存期(overall survival OS),性别与吸烟状态等参数的相关性,并得出相应的危险比(Hazard ratio,HR)、95%置信区间(CI)和P值。结果研究结果显示:高表达EGFR、BRAF、MET、RET、ROS-1的患者有较好的OS。进一步引入吸烟状态和性别参数显示,BRAF、MET,PIK3CA、HER-2、ALK的表达与患者的吸烟状态存在相关性(P<0.05)。BRAF、MET、EGFR、ALK表达与OS的相关性存在性别差异(P<0.05)。结论各驱动基因在患者预后评判中既是独立因素,又相互作用,吸烟状态与性别也是决定患者预后的关键因素,提示临床治疗时要对患者进行综合的评判,要进行多基因的共同分析、多靶点的联合治疗才能使病人获得更大的收益。

Prognostic Value of Expression of Driver Gene in Non-Small Cell Lung Cancer

Objective To explore the expression of EGFR、KRAS、BRAF、PIK3CA、ALK、MET、HER-2、RET、ROS-1 in non-small cell lung cancer(NSCLC)and its correlation with overall survival(OS),and to find more effective molecular targets for NSCLC prevention and treatment.Methods Kaplan-Meier(KM)plotter online database was used to analyze the correlation among the expression of EGFR、KRAS、BRAF、PIK3CA、ALK、MET、HER-2、RET、ROS-1 correlated with overall survival(OS)and smoking status and gender difference of NSCLC patients,and hazard ratio(HR),95% confidence interval(CI),and p value were determined.Results The study show that the high expression level of EGFR、BRAF、MET、RET、ROS-1 was associated with better overall survival(OS)for NSCLC patients(P<0.05).Prognostic value of EGFR、KRAS、BRAF、PIK3CA、ALK、MET、HER-2、RET、ROS-1 in different smoking status had difference.The expression of BRAF、MET、PIK3CA、HER-2、ALK was related to smoking status(P<0.05).BRAF、MET、EGFR、ALK was related to gender difference(P<0.05).Conclusion The results suggested that each driving gene have different values in predicting the prognosis of NSCLC,and each gene is not only an independent factor,but also interacts with each other in the prognosis evaluation.Smoking status and gender difference are also the key factors to determine the prognosis of patients.The results suggested that we should be comprehensively analyze in clinical treatment,and multi-genes and multi-target treatment should be carried out greater benefits to NSCLC patients.