血浆EGFR水平与接受放疗的非小细胞肺癌患者总生存时间相关性研究

【目的】探讨接受胸部放疗的非小细胞肺癌（NSCLC）患者外周血中可溶性表皮生长因子受体（EGFR）水平与患者总生存时间（OS）的相关性。【方法】选择111例局部晚期的 NSCLC 患者，均接受单纯胸部放疗或者同步放化疗，并于放疗开始前采集外周静脉血，采用 ELISA 法检测血浆可溶性 EGFR 水平。治疗完成后定期随访生存状况。【结果】所有患者放疗前血浆可溶性 EGFR 水平为34．9（17．5～70．2） ng／mL ，高于此中位浓度的患者的中位 OS 为30．0个月，低于此中位浓度的患者的中位 OS 为10．1个月，EGFR 水平高者中位 OS 显著高于水平低者，差异具有统计学意义（ P ＜0．01）。多因素分析显示不吸烟／既往吸烟，腺癌，同步放化疗及基线 EGFR ≥34．9 ng／mL 是 OS 延长的独立预后因素（均 P ＜0．05）。【结论】血浆可溶性 EGFR可作为判断接受胸部放疗的局部晚期 NSCLC 患者预后的一项生物学标记物。

A Study on the Correlation between the Plasma Epidermal Growth Factor Receptor Level and O-verall Survival in Non-Small Cell Lung Cancer Patients Receiving Radiotherapy

Objective]To investigate the correlation between the plasma soluble epidermal growth factor receptor (EGFR) level and the overall survival (OS) in non‐small cell lung cancer(NSCLC)patients receiving radiation therapy .[Methods]The 111 patients with locally advanced non‐small cell lung cancer who were trea‐ted with thoracic radiotherapy or concurrent chemoradiotherapy were recruited for this study .Plasma samples were obtained before radiotherapy and soluble EGFR was measured by ELISA .Overall survival of each patient was followed up after the radiotherapy .[Results]The range of the plasma soluble EGFR level was 17 .5 ~ 70 .2 ng/mL ,with the median value of 34 .9 ng/ml .Using this level as the cut‐off ,the median OS was 30 .0 and 10 .1 months for patients with higher and lower levels ( P < 0 .01) .Multi‐variant analysis showed that non‐smoker/former smoker ,adenocarcinoma ,concurrent chemo‐radiotherapy and baseline high EGFR level ( ≥ 34 .9 ng/mL) were independent prognostic factors ,with all P values < 0 .05 .[Conclusion]Plasma soluble EGFR level may serve as an independent prognostic biomarker for NSCLC patients treated with thoracic radiotherapy .