摘要
目的探讨第3代酪氨酸激酶抑制剂(EGFR-TKIs)二线治疗伴T790M突变晚期肺腺癌病人生存预后影响因素。方法回顾性纳入2017年6月至2020年6月于镇江市第一人民医院接受奥希替尼二线治疗伴T790M突变晚期肺腺癌病人共142例,分析临床病理资料和随访生存资料,采用单因素和多因素法评价病人无进展生存时间独立影响因素。结果单因素分析结果显示,一代EGFR-TKI治疗后无进展生存时间[9.0月比13.0月]和人类增殖细胞核抗原Ki-67表达水平分别为<30%、30%~60%、>60%的无进展生存时间[16.0月比12.0月比9.0月]与奥希替尼二线治疗伴T790M突变晚期肺腺癌病人无进展生存时间有关(P<0.05);Cox回归模型分析结果显示,一代EGFR-TKI治疗后无进展生存时间和Ki-67表达水平是奥希替尼二线治疗伴T790M突变晚期肺腺癌病人无进展生存时间独立影响因素(P<0.05)。结论第3代EGFR-TKIs二线治疗伴T790M突变晚期肺腺癌病人生存预后与一代EGFR-TKI治疗后无进展生存时间和Ki-67表达水平关系密切;其中一代EGFR-TKI治疗后无进展生存时间>10个月和Ki-67表达水平<30%者二线治疗后无进展生存时间往往更长。
Objective To explore the factors affecting the survival and prognosis of patients with advanced lung adenocarcinoma with the T790M mutation treated with the third-generation tyrosine kinase inhibitors(EGFR-TKIs).Methods A total of 142 patients with advanced lung adenocarcinoma with the T790M mutation who received second-line treatment with osimertinib at Zhenjiang First People's Hospital from June 2017 to June 2020 were retrospectively included.The clinicopathological data and follow-up survival data were analyzed,and the independent influencing factors of progression-free survival time of patients were evaluated by univariate and multivariate methods.Results The results of univariate analysis showed that the progression-free survival time after generation EGFRTKI therapy[9.0 months versus 13.0 months]and the levels of human proliferating cell nuclear antigen Ki-67 expression of<30%,30%-60%,and>60%,respectively,were associated with progression-free survival time after second-line treatment with osimertinib with the T790M mutation in advanced lung adenocarcinoma patients(P<0.05).Cox regression model analysis showed that the progression-free survival time and Ki-67 expression level after first-generation EGFR-TKI therapy were independent factors influencing progression-free survival time in patients with advanced lung adenocarcinoma with the T790M mutation treated with second-line osimertinib(P<0.05).Conclusions The survival prognosis of patients with advanced lung adenocarcinoma with the T790M mutation treated with 3rd generation EGFR-TKIs as a second-line treatment is closely related to the progression-free survival time and Ki-67 expression level after first generation EGFR-TKI treatment.Among them,progression-free survival time>10 months after first-generation EGFR-TKI therapy and Ki-67 expression level<30%tended to be longer after second-line therapy.
作者
成美英
王雅丽
周永静
偰燕燕
孙小迪
王馨
CHENG Meiying;WANG Yali;ZHOU Yongjing;XIE Yanyan;SUN Xiaodi;WANG Xin(Department of Oncology,Zhenjiang First People´s Hospital,Zhenjiang,Jiangsu 212000,China)
出处
《安徽医药》
CAS
2023年第4期823-826,共4页
Anhui Medical and Pharmaceutical Journal
关键词
癌
非小细胞肺
酪氨酸激酶抑制剂
增殖细胞核抗原
奥希替尼
突变
肺腺癌
无进展生存时间
预后
Carcinoma,non-small-cell lung
Tyrosine kinase inhibitor
Proliferating cell nuclear antigen
Oxitinib
Mutation
Lung adenocarcinoma
Progression-free survival time
Prognosis
