本文選題：肺腫瘤 + 酪氨酸激酶抑制劑　； 參考：《中國肺癌雜志》2017年08期

【摘要】：背景與目的通過對85例肺腺癌患者石蠟包埋標本及部分全血樣本BIM缺失多態(tài)性的檢測,分析BIM多態(tài)性與酪氨酸激酶抑制劑(tyrosine kinase inhibitors,TKIs)藥物療效相關性,初探不同類型標本BIM檢測的相關性。方法收集2013年2月-2014年11月間經(jīng)宣武醫(yī)院胸外科診斷明確的IIIb期-IV期肺腺癌患者,表皮生長因子受體(epidermal growth factor receptor,EGFR)19或21外顯子突變85例,給予一線TKIs治療,采用石蠟組織標本和部分全血進行BIM基因多態(tài)性檢測,分析兩組患者治療客觀有效率(objective response rate,ORR)、無進展生存期(progression-free survival,PFS),并根據(jù)吸煙、性別、EGFR突變位點等因素進行單因素分析,同時對比石蠟標本與血液檢測BIM的相關性。結(jié)果在受檢的85例FFPE樣本中,BIM基因具有缺失多態(tài)性14例(16.47%),純和無缺失多態(tài)性71例(83.53%)。在13例對照樣本中,石蠟樣本和血液樣本檢出BIM基因缺失多態(tài)性2例,且為相同患者樣本。BIM多態(tài)性的患者在用藥物后的客觀緩解率與無多態(tài)性組無統(tǒng)計學差異(P0.05)。BIM基因缺失多態(tài)性、純和無缺失患者接受藥物治療的中位PFS分別為7.1個月、12.8個月,存在統(tǒng)計學差異(P=0.013)。男性和女性中位PFS(10.7個月、12.1個月,P=0.835)、吸煙組和非吸煙組中位PFS(9.7個月、12.1個月,P=0.974)、EGFR 19和21外顯子中位PFS(8.7個月、12.2個月,P=0.303)比較均無統(tǒng)計學差異(P0.05)。結(jié)論檢測患者BIM基因多態(tài)性對晚期肺腺癌EGFR-TKIs治療患者的評估預后可能有一定參考意義,但需要進行大樣本的研究。
[Abstract]:Background & objective to investigate the association between BIM-deletion polymorphism and tyrosine kinase inhibitors (TKIsa) in 85 paraffin-embedded lung adenocarcinoma patients and some whole blood samples. To explore the correlation of BIM detection in different types of specimens. Methods 85 patients with stage IIIb stage IV lung adenocarcinoma diagnosed by thoracic surgery in Xuanwu Hospital from February 2013 to November 2014 were enrolled in this study. 85 cases of epidermal growth factor receptor EGFRN 19 or 21 exon mutation were treated with first-line TKIs. The BIM gene polymorphism was detected in paraffin tissue samples and partial whole blood. The objective effective rate of two groups was analyzed. The progressive free survival (PFSs) of the two groups were analyzed according to smoking, sex and EGFR mutation sites. At the same time, the correlation between paraffin and blood BIM was compared. Results among 85 FFPE samples, 14 had deletion polymorphism of BIM gene (16.47%) and 71 cases had pure or no deletion polymorphism (83.53%). BIM gene deletion polymorphism was detected in 2 cases in paraffin and blood samples. There was no significant difference in the objective remission rate between the patients with BIM polymorphism and those without drug use. The median PFS of pure and non-deletion patients were 7.1 months and 12.8 months, respectively. There was a statistical difference between P0. 013 and P0. 013. There was no statistical difference between male and female median PFSN 10.7 months (12.1 months), smoking group (9.7 months) and non-smoking group (12.1 months). Conclusion Detection of BIM gene polymorphism in patients with advanced lung adenocarcinoma may be helpful in evaluating prognosis of patients with advanced lung adenocarcinoma, but large sample study is needed.
【作者單位】： 首都醫(yī)科大學宣武醫(yī)院胸外科 首都醫(yī)科大學肺癌診療中心;
【基金】：國家重點基礎研究發(fā)展計劃——中國人類蛋白質(zhì)組草圖(No.2014CBA02004)資助~~
【分類號】：R734.2

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