| 成美英,王雅丽,周永静,等.第 3代酪氨酸激酶抑制剂二线治疗伴 T790M突变晚期肺腺癌 142例生存预后影响因素[J].安徽医药,2023,27(4):823-826. |
| 第 3代酪氨酸激酶抑制剂二线治疗伴 T790M突变晚期肺腺癌 142例生存预后影响因素 |
| Survival prognostic factors of 142 cases of advanced lung adenocarcinoma with T790M mutation treated with a third-generation tyrosine kinase inhibitor as a second-line treatment |
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| DOI：10.3969/j.issn.1009-6469.2023.04.044 |
| 中文关键词: 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 |
| 英文关键词: Carcinoma,non-small-cell lung Tyrosine kinase inhibitor Proliferating cell nuclear antigen Oxitinib Mutation Lung adenocarcinoma Progression-free survival time Prognosis |
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| 中文摘要: |
| 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。 |
| 英文摘要: |
| Objective To explore the factors affecting the survival and prognosis of patients with advanced lung adenocarcinomawith 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 FirstPeople′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. |
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