【摘要】：[目的]探討基于EGFR、KRAS、ALK及EGFR分子亞型非小細胞肺癌患者臨床病理特征和預(yù)后情況的差異。[方法]回顧性分析2002年7月～2013年2月就診于中國醫(yī)學(xué)科學(xué)院腫瘤醫(yī)院的1975例非小細胞肺癌患者的臨床和病理特征,包括年齡、性別、吸煙狀況、家族史、臨床分期、腫瘤分期、腫瘤大小、病理類型及分化程度并通過電話隨訪獲得患者生存資料。分析基于不同分子病理分型非小細胞肺癌患者臨床病理特征和預(yù)后情況差異。[結(jié)果]EGFR陽性突變尤其經(jīng)典突變腫瘤生物學(xué)行為良好,中位生存期為61.6月；KRAS突變陽性高發(fā)于50歲以上吸煙男性患者,中位生存期為26.0月；ALK融合基因陽性高發(fā)于年輕不吸煙女性,具有更強的轉(zhuǎn)移能力,中位生存期為32.3月。吉非替尼、厄洛替尼、埃克替尼具有類似的臨床療效,同化療相比均不改善EGFR陽性非小細胞肺癌患者的總生存期。[結(jié)論]EGFR、KRAS、ALK陽性非小細胞肺癌患者具有不同的臨床病理特點和預(yù)后情況。行EGFR、KRAS、ALK病理檢測分析對判斷非小細胞肺癌患者臨床病理特征和預(yù)后具有臨床指導(dǎo)意義。
[Abstract]:[objective] to investigate the differences in clinicopathological features and prognosis of patients with non-small cell lung cancer (NSCLC) based on EGFR KRASA ALK and EGFR molecular subtypes. [methods] the clinical and pathological features of 1975 patients with non-small cell lung cancer (NSCLC) from July 2002 to February 2013 were analyzed retrospectively, including age, sex, smoking status, family history and clinical stage. Tumor staging, tumor size, pathological type and differentiation were obtained by telephone follow-up. To analyze the difference of clinicopathological features and prognosis of non-small cell lung cancer patients based on different molecular pathological classification. [results] the biological behavior of EGFR positive mutation, especially classical mutation, was good. The median survival time was 61.6 months and the median survival time was 26.0 months in smoking men over 50 years old. The positive rate of ALK fusion gene was high in young non-smoking women and had stronger metastatic ability. The median survival time was 32. 3 months. Gefitinib, erlotinib, and ectini have similar clinical efficacy and do not improve the overall survival time of patients with EGFR positive NSCLC compared with chemotherapy. [conclusion] EGFR KRASALK positive NSCLC patients have different clinicopathological features and prognosis. The pathological examination and analysis of EGFR KRASL ALK are of clinical significance in judging the clinicopathological characteristics and prognosis of NSCLC patients.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級別】：博士
【學(xué)位授予年份】：2015
【分類號】：R734.2
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本文編號：2169234