化疗对晚期非小细胞肺癌患者表皮生长因子受体基因突变状态的影响

目的 探讨化疗对晚期非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)基因突变状态的影响.方法 选取85例晚期NSCLC患者作为研究对象.化疗前、化疗4~6个周期后均采集所有研究对象的外周血,采用酶切富集联合变性高效液相色谱法(REDE-DHPLC)检测EGFR-19外显子、EGFR-21外显子的突变状态.结果 85例晚期NSCLC患者化疗前EGFR突变阳性率为55.29%(47/85),化疗4~6个周期后EGFR突变阳性率为35.29%(30/85),化疗前后EGFR突变阳性率比较差异有统计学意义(P<0.05).化疗前后共有37例晚期NSCLC患者发生EGFR突变,其中27例从EGFR突变阳性转为EGFR突变阴性,10例患者从EGFR突变阴性转为EGFR突变阳性,两种突变模式发生率比较差异有统计学意义(P<0.05).结论 晚期NSCLC患者化疗过程中EGFR突变状态可能会发生改变,因此在给予其靶向治疗前应重新对其进行EGFR突变检查.

Influence of Chemotherapy on Epidermal Growth Factor Receptor Gene Mutations in Patients with Advanced Non-small Cell Lung Cancer

Objective To investigate the influence of chemotherapy on epidermal growth factor receptor gene ( EGFR) mutations in patients with advanced non-small cell lung cancer(NSCLC).Methods 85 cases of advanced NSCLC were selected. Peripheral blood was collected from all the subjects before and after 4~6 cycles of chemotherapy ,then EGFR exon 19 and exon 21 mutations were detected by restriction endonuclease digestion combine with denaturing high performance liquid chromatography (REDE-DHPLC).Results The EGFR mutation positive rate was 55.29% (47/85) in 85 cases of advanced NSCLC before chemotherapy ,then the EGFR mutation positive rate converted to 35.29%after 4~6 cycles of chemotherapy .There was statistical difference in EGFR mutation positive rate between before and after chemotherapy (P<0.05).37 cases of advanced NSCLC had EGFR mutations before and after chemotherapy ,including 27 cases from positive EGFR mutation to negative EGFR mutation ,10 patients from negative EGFR mutation to positive EGFR mutation .There was statistical difference in incidence rate between 2 kinds of mutation models(P<0.05).Conclusion EGFR mutation status may change during chemotherapy in patients with ad-vanced NSCLC ,so it should be re-examined before targeted therapy .