摘要
目的探究表皮生长因子受体(EGFR)基因突变在非小细胞肺癌(NSCLC)患者脑转移放疗疗效预测中的价值。方法收集60例NSCLC脑转移患者临床资料,依照NSCLC患者脑转移放疗疗效分为疗效良好组(49例)和疗效不良组(11例)。比较不同放疗疗效患者的基础资料、EGFR基因突变情况及EGFR血浆含量;分析NSCLC脑转移放疗疗效的影响因素,评估EGFR基因突变及其他影响因素对NSCLC患者脑转移放疗疗效的预测价值。结果2组性别、年龄、吸烟状况、脑转移数目、卡氏评分比较,差异无统计学意义(P>0.05);2组淋巴结转移、肿瘤分期差异有统计学意义(P<0.05)。疗效良好组EGFR基因突变率(53.06%)高于疗效不良组(18.18%),差异有统计学意义(χ^(2)=5.307,P=0.021)。疗效良好组EGFR表达水平低于疗效不良组,差异有统计学意义(t=2.376,P=0.021)。将NSCLC脑转移放疗疗效作为因变量,EGFR基因突变、淋巴结转移、肿瘤分期作为自变量,进行逻辑回归分析,结果显示,EGFR基因突变是NSCLC患者脑转移放疗疗效的保护因素,淋巴结转移、肿瘤分期Ⅲ~Ⅳ期、EGFR高水平是NSCLC患者脑转移放疗疗效的危险因素。四者联合预测NSCLC脑转移放疗疗效良好的公式为Log(P)=-2.849×EGFR基因突变+2.192×淋巴结转移+1.388×肿瘤分期+1.658×EGFR水平-2.062。ROC曲线分析结果显示,EGFR基因突变对NSCLC患者脑转移放疗疗效良好的预测价值良好,灵敏度为0.818,特异度为0.610,AUC为0.714,EGFR基因突变、淋巴结转移、肿瘤分期、EGFR水平联合对NSCLC患者脑转移放疗疗效的预测价值相对单一指标较好,灵敏度、特异度较高。结论EGFR基因突变可能与NSCLC患者脑转移放疗疗效有关。EGFR基因突变与淋巴结转移、肿瘤分期、EGFR水平联合对NSCLC患者脑转移放疗疗效有良好的预测价值,EGFR基因突变可能成为临床上预测NSCLC脑转移放疗疗效的一个评价因子。
Objective To explore the value of epidermal growth factor receptor(EGFR)gene mutation in predicting the efficacy of brain metastases radiotherapy in patients with non-small cell lung cancer(NSCLC).Methods Clinical data of 60 NSCLC patients with brain metastases were collected.NSCLC patients were divided into good group(49 cases)and poor group(11 cases)according to the therapeutic effect of brain metastases radiotherapy.The basic data,EGFR gene mutation and EGFR plasma content of patients with different radiotherapy efficacy were compared.To analyze the factors influencing the efficacy of BMS in NSCLC patients,and to evaluate the predictive value of EGFR gene mutation and other factors for BMS in NSCLC patients.Results There were no significant differences in gender,age,smoking status,number of brain metastases and Cassiar score between the 2 groups(P>0.05),while there were statistical differences in lymph node metastasis and tumor stage between the 2 groups(P<0.05).The mutation rate of EGFR gene in the good treatment group(53.06%)was higher than that in the poor treatment group(18.18%),and the difference was statistically significant(χ^(2)=5.307,P=0.021).The expression level of EGFR in the group with good efficacy was lower than that in the group with poor efficacy,and the difference was statistically significant(t=2.376,P=0.021).The effect of NSCLC BMS radiotherapy were taken as dependent variables,and EGFR gene mutation,lymph node metastasis and tumor stage were taken as independent variables.The results of logistic regression analysis showed that EGFR gene mutation was a protective factor for BMS radiotherapy effect in NSCLC patients.Lymph node metastasis,tumor stageⅢtoⅣ,and high EGFR level are risk factors for the efficacy of BMS in NSCLC patients.The formula for predicting the good effect of BMS in NSCLC combined with the four methods was Log(P)=-2.849×GFR gene mutation+2.192 lymph node metastasis+1.388 t-umor stage+1.658×GFR level-2.062.ROC curve analysis results showed that EGFR gene mutation had good predictive value for good BMS radiotherapy efficacy in NSCLC patients,with sensitivity of 0.818,specificity of 0.610 and AUC of 0.714.The combination of EGFR gene mutation,lymph node metastasis,tumor stage and EGFR level has better predictive value for BMS radiotherapy efficacy in NSCLC patients than a single index,with higher sensitivity and specificity.Conclusion EGFR gene mutation may be related to the efficacy of BMS in NSCLC patients.The combination of EGFR gene mutation,lymph node metastasis,tumor stage,and EGFR level has good predictive value for BMS radiotherapy efficacy in NSCLC patients,and EGFR gene mutation may be an evaluation factor for predicting BMS radiotherapy efficacy in NSCLC patients clinically.
作者
孟宪宇
张萍
张赛
MENG Xianyu;ZHANG Ping;ZHANG Sai(Anyang Cancer Hospital,Anyang,455000)
出处
《实用癌症杂志》
2025年第1期49-53,共5页
The Practical Journal of Cancer
关键词
EGFR
基因突变
非小细胞肺癌
脑转移
放疗
疗效
预测
EGFR
Gene mutation
Non-small cell lung cancer
Brain metastases
Radiotherapy
Curative effect
Forecast
