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目的:检测非小细胞肺癌(NSCLC)根治术后患者表皮生长因子受体(EGFR)基因突变率,探讨突变型和野生型患者辅助化疗疗效及毒性反应差异。方法:收集术后NSCLC组织,以ARMS法行EGFR基因检测;高危IB-IIIA期患者接受标准含铂两药化疗;化疗后随访18个月,定期行全身检查。结果:40例组织中检出突变19例,总突变率47.5%。突变率:鳞癌22.2%;腺癌68.2%;女72.7%,男37.9%。辅助化疗28例,副反应表现为胃肠反应及骨髓抑制。突变组DFS6个月为100%,12个月为100%,18个月为90.9%;野生组DFS6个月为70.6%,12个月为47.1%,18个月为35.3%。结论:NSCLC患者EGFR突变率腺癌较鳞癌高;女性较男性高。术后EGFR突变组较野生组辅助化疗12个月及18个月DFS高,而副反应无差异。
OBJECTIVE: To determine the mutation rate of epidermal growth factor receptor (EGFR) gene in patients with non-small cell lung cancer (NSCLC) after radical surgery and to investigate the efficacy and toxicity of adjuvant chemotherapy in patients with both mutant and wild type. Methods: The postoperative NSCLC tissues were collected to detect the EGFR gene by ARMS method. The patients in high risk IB-IIIA group received standard platinum-containing two-drug chemotherapy. The patients were followed up for 18 months after chemotherapy, and the whole body examination was performed regularly. Results: Twenty-nine cases were found in 40 cases with a total mutation rate of 47.5%. Mutation rate: squamous cell carcinoma 22.2%; adenocarcinoma 68.2%; female 72.7%, male 37.9%. Adjuvant chemotherapy in 28 cases, the side effects of gastrointestinal reactions and bone marrow suppression. Mutation group DFS 6 months was 100%, 12 months was 100%, 18 months was 90.9%; wild group DFS 6 months was 70.6%, 12 months was 47.1%, 18 months was 35.3%. Conclusion: EGFR mutation rates in NSCLC patients are higher than those in squamous cell carcinomas. Women are higher than men. Postoperative EGFR mutation group than the wild-group chemotherapy 12 months and 18 months DFS high, but no difference in side effects.