Objective To summarize the driver gene mutations in patients with advanced non-small cell lung cancer(NSCLC)in Ji'nan region,investigate the effectiveness of first-line treatment with gefitinib in patients with epidermal growth factor receptor(EGFR)mutation,and identify predictive factors affecting prognosis.Methods Next-generation sequencing(NGS)was used to detect the driver gene mutations in 201 patients with advanced NSCLC admitted to Handan Central Hospital from January to June 2021.A total of 91 patients with EGFR mutations receiving gefitinib-targeted therapy were followed up to collect the survival data.Kaplan-Meier method was used to analyze the median progression-free survival(mPFS)of patients with various factors after treatment with gefitinib.Log-rank test was utilized to evaluate the survival difference.A risk assessment model was developed using Cox regression to analyze the effects of different risk factors on the effectiveness and the prognosis of gefitinib patients.Results Of the 201 patients with advanced NSCLC,138(68.66％)had at least one gene mutation.EGFR was the most common mutation(91 cases,52.6％),mainly EGFR exon 19 deletion(33.6％)and EGFR exon 21 L858R point mutation(42.7％).Forty patients(43.96％)had complex mutations.Kaplan-Meier survival analysis and Log-rank test showed that the mPFS of patients with EX19 del,EX21 L858R mutation,and rare and complex mutation was 17.0,13.0 and 8.0 months,respectively,and the difference between the three groups was statistically significant(P＜0.05).The mPFS was higher in patients without pleural effusion than that of patients with pleural effusion(17.0 months vs 10.0 months,P=0.005).Cox regression analysis revealed that the type of EGFR mutation was an independent factor affecting the mPFS of NSCLC patients(P＜0.05).Conclusion In patients with advanced NSCLC in Ji'nan region,EGFR is a gene with a high mutation frequency.The type of driver mutation can be used as an independent predictor to evaluate the survival of patients after targeted gefitinib therapy.Patients with rare or complex mutations have a poor prognosis.
关键词
表皮生长因子受体/吉非替尼/基因突变/二代测序/非小细胞肺癌
Key words
epidermal growth factor receptor/gefitinib/gene mutation/next-generation sequencing/non-small cell lung cancer
维普
万方数据