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目的:研究表皮生长因子受体(epidermal growth factor receptor,EGFR)基因第1内含子区CA简单重复序列(simple sequence repeat,SSR)多态性与晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者应用表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinase inhibitors,EGFR-TKIs)治疗的临床疗效间的关系。方法:观察101例晚期NSCLC患者使用EGFR-TKIs的临床疗效及生存情况,通过对患者EGFR-TKIs治疗前外周血进行EGFR基因第1内含子的PCR扩增,并对PCR扩增产物直接进行序列测定,分析CA-SSR多态性与EGFR-TKIs治疗的临床疗效和患者生存情况间的关系。结果:EGFR-TKIs治疗后,24例(23.8%)患者部分缓解(partial response,PR),46例(45.5%)患者为疾病稳定(stable disease,SD),临床受益(PR+SD)患者为70例(69.3%)。腺癌和女性患者的中位生存期(median survival time,MST)较非腺癌和男性患者明显延长(P<0.05)。CA-SSR出现频率最多的CA等位基因为(CA)20[68.7%(68/99)],短CA-SSR组患者经EGFR-TKIs治疗后的无进展生存(progression-free survival,PFS)时间比长CA-SSR患者明显延长(P=0.039);短CA-SSR组MST为15.7个月,长CA-SSR组MST为14.4个月,组间差异无统计学意义(P=0.691)。结论:EGFR-TKIs治疗可明显延长腺癌、女性NSCLC患者的MST和短CA-SSR患者的PFS。
Objective: To investigate the association between simple sequence repeat (SSR) polymorphisms in the first intron region of epidermal growth factor receptor (EGFR) gene and non-small cell lung cancer , NSCLC) patients with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) treatment of clinical efficacy. Methods: The clinical efficacy and survival of EGFR-TKIs in 101 patients with advanced non-small cell lung cancer (NSCLC) were observed. PCR was performed on the first intron of EGFR gene in peripheral blood of patients with EGFR-TKIs before treatment and the PCR products were directly processed Sequence analysis, analysis of CA-SSR polymorphism and EGFR-TKIs treatment of clinical efficacy and the relationship between the survival of patients. RESULTS: After EGFR-TKIs treatment, partial response (PR) was found in 24 patients (23.8%) and stable disease (SD) in 46 patients (45.5%). The patients with clinical benefit (PR + SD) 70 cases (69.3%). The median survival time (MST) was significantly longer in adenocarcinoma and female than in non-adenocarcinoma and male (P <0.05). The CA allele with the highest frequency of CA-SSR was (CA) 20 [68.7% (68/99)]. The progression-free survival (PFS) of patients with short CA-SSR after EGFR- (P = 0.039). The MST in short CA-SSR group was 15.7 months and that in long CA-SSR group was 14.4 months. There was no significant difference between the two groups (P = 0.691). Conclusion: EGFR-TKIs treatment can significantly prolong the PFS of patients with adenocarcinoma and female NSCLC with MST and short CA-SSR.