發(fā)布時間：2018-04-25 21:46

  本文選題：非小細胞肺癌 + EGFR��； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：背景和目的:肺癌是目前全球范圍內(nèi)發(fā)病率和死亡率最高的惡性腫瘤。據(jù)報道,2015年我國肺癌患者新增73.33萬人,死亡61.02萬人,居于榜首。非小細胞肺癌(non-small cell lung cancar,NSCLC)約占原發(fā)性肺癌的85%,并且有超過70%的患者在就診時已屬于局部晚期或發(fā)生遠處轉(zhuǎn)移。分子靶向治療在晚期非小細胞肺癌的中起到的作用越來越重要。EGFR突變是NSCLC患者中最常見的基因突變類型,目前針對EGFR的治療是NSCLC治療中療效最確切、應(yīng)用最廣泛的驅(qū)動基因靶向治療。很多國際指南都推薦晚期非小細胞肺癌在治療前先進行EGFR突變檢測,在許多國家EGFR突變檢測廣泛應(yīng)用并成為臨床常規(guī)檢測項目,以此確�；颊咴谥委熯^程中接受最合適的治療方案。本項研究目的是收集吉林大學(xué)第一醫(yī)院晚期非小細胞肺癌患者EGFR檢測現(xiàn)狀的數(shù)據(jù),包括EGFR送檢比例(檢測率),分析影響送檢EGFR檢測的相關(guān)因素;分析EGFR突變檢測結(jié)果與一般臨床病理特征之間的關(guān)系;統(tǒng)計EGFR突變檢測結(jié)果。方法:收集2014年1月1日~2015年12月31日期間在吉林大學(xué)第一醫(yī)院住院的首次確診或術(shù)后復(fù)發(fā)的晚期非小細胞肺癌(ⅢB~Ⅳ期)患者353例。結(jié)果應(yīng)用SPSS21.0進行統(tǒng)計學(xué)分析,采用χ2檢驗或Fisher精確概率法進行各臨床特征及人口統(tǒng)計學(xué)對EGFR基因突變情況分析。結(jié)果:1.353例患者中,178例患者送檢EGFR基因突變檢測,檢測率為50.4%,其中EGFR突變陽性的81例(45.5%)。最常見的為19、21號外顯子,突變亞型最多的為21-L858R,共35例(43.2%),其次為19-del,共32例(39.5%)。最常用的EGFR突變檢測方法為ARMS法。2.本研究共353例患者,男性組209例,送檢患者84例,檢測率為40.2%%;女性組144例,送檢患者94例,檢測率為65.3%%。吸煙指數(shù)400組204例,送檢患者130例,檢測率為63.7%;吸煙指數(shù)≥400組149例,送檢患者48例,檢測率為32.2%。腺癌組249例,送檢患者165例,檢測率為66.3%;非腺癌組104例,送檢患者13例,檢測率為12.5%。組織學(xué)標(biāo)本組共266例,送檢患者135例,檢測率為50.8%;脫落細胞組共66例,送檢患者43例,檢測率為65.2%;其他無充足樣本的共21例,送檢患者0例。差異均有統(tǒng)計學(xué)意義(P0.05)。3.送檢EGFR檢測的178例患者,吸煙指數(shù)400組130例,突變型65例,突變率為50.0%,吸煙指數(shù)≥400組48例,突變型16例,突變率為33.3%;腺癌組165例,突變型79例,突變率為47.9%,非腺癌組13例,突變型2例,突變率為15.4%;M0的患者24例,突變型4例,突變率16.7%;M1的患者154例,突變型77例,突變率50.0%。差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1.EGFR基因突變檢測的檢測率為50.4%,EGFR突變陽性率45.5%。EGFR基因突變檢測與病理類型(腺癌)相關(guān),與年齡、性別、吸煙指數(shù)、醫(yī)保類型、標(biāo)本類型無明顯相關(guān)性。2.EGFR突變常見于吸煙指數(shù)400,腺癌,有遠處轉(zhuǎn)移的非小細胞肺癌患者。3.EGFR基因突變主要發(fā)生在19、21號外顯子。最常用的EGFR突變檢測方法為ARMS法。
[Abstract]:Background and objective: lung cancer is one of the most common malignant tumors in the world. According to reports, in 2015, China's lung cancer patients increased by 733300 people, 610200 deaths, ranked first. Non-small cell lung cancer (NSCLC) accounts for 85% of primary lung cancer, and more than 70% of the patients were locally advanced or distant metastases at the time of visit. Molecular targeting therapy plays an increasingly important role in the treatment of advanced non-small cell lung cancer. EGFR mutation is the most common type of gene mutation in patients with NSCLC. At present, the treatment of EGFR is the most effective in the treatment of NSCLC. The most widely used driving gene targeting therapy. Many international guidelines recommend EGFR mutation detection before treatment for advanced non-small cell lung cancer. EGFR mutation detection is widely used in many countries and has become a routine clinical test. This ensures that patients receive the most appropriate treatment during the course of treatment. The purpose of this study was to collect the data of EGFR detection status of patients with advanced non-small cell lung cancer (NSCLC) in the first Hospital of Jilin University, including the proportion of EGFR (detection rate), and analyze the related factors that affect the EGFR detection. The relationship between EGFR mutation detection and general clinicopathological features was analyzed, and the results of EGFR mutation detection were analyzed. Methods: from January 1, 2014 to December 31, 2015, 353 patients with advanced non-small cell lung cancer (stage 鈪，

本文編號：1803114