非小细胞肺癌EGFR基因突变阳性的临床意义

目的：探讨非小细胞肺癌表皮生长因子受体（EGFR）第19、21号外显子突变与其临床病理特征、家族史的关系，以及对突变阳性患者使用表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）靶向治疗的效果。方法采用扩增阻滞突变系统聚合酶链反应技术对EGFR第19、21号外显子进行检测。结果162例非小细胞肺癌患者发生EGFR突变阳性63例，突变阳性率为38.89%。腺癌、女性、非吸烟者、有肺癌及其他恶性肿瘤家族史的非小细胞肺癌患者EGFR突变率明显升高，差异有统计学意义（P0.05）。非小细胞肺癌发生EGFR突变阳性使用EGFR-TKIs靶向治疗患者的中位生存期明显长于未治疗及其他药物化疗患者，差异有统计学意义（P〈0.01）。结论非小细胞肺癌患者EGFR突变筛查应作为常规临床检测指标，特别是对于有肿瘤家族史患者更具有临床意义。

Clinical significance of EGFR gene mutations in non-small cell lung cancer

Objective To investigate the associations between the mutations of exons 19 and 21 of epidermal growth fac-tor receptor（EGFR） genes and clinicopathological characteristics,and family history in non-small cell lung cancer（NSCLC）,and further explore the curative effect of targeted therapy in patients with positive mutations by epidermal growth factor receptor tyrosine kinase inhibitors（EGFR-TKIs）. Methods Amplification Refractory Mutation System-Polymerase Chain Reaction（ARMS-PCR） was applied to detect the mutations of exons 19 and 21 of EGFR. Results The results showed that 63 patients were with EGFR muta-tions in 162 NSCLC patients,and the positive rate of mulation was 38.89%. Furthermore,the mutation rate was obviously higher in NSCLC patients with adenocarcinoma,woman,non-smoking,lung cancer or family history of malignancy,and the difference had statistical significance（P0.05）. The median survival time of the NSCLC patients,who were treated with EGFR-TKIs,was prolonged significantly in patients with positive mutationwith statistically significant difference （P〈0.01）. Conclusion The screening of EGFR mutations should be used as a routine examination in the patients with NSCLC ,especially it has more clinical significance in patients with family history of malignant tumor.