摘要
目的探讨埃克替尼治疗表皮生长因子受体(EGFR)突变型非小细胞肺癌(NSCLC)效果的影响因素及预测指标。方法纳入64例EGFR突变型的NSCLC患者,均接受埃克替尼治疗。分析治疗期间不良反应及耐药发生情况。比较不同临床特征患者的治疗效果,采用Cox回归模型分析埃克替尼治疗效果的影响因素,并采用受试者工作特征(ROC)曲线分析相关指标对埃克替尼治疗效果的预测价值。结果有6例(9.4%)、8例(12.5%)、45例(70.3%)分别出现原发性耐药、局部耐药、缓慢耐药,不良反应均较轻。治疗前的CD3^+T细胞比例、CD4^+T细胞比例、CD4^+/CD8^+T细胞比值是埃克替尼治疗效果的影响因素(均P<0.05)。CD4^+T细胞比例预测埃克替尼疗效的ROC曲线曲线下面积达0.819,特异度和敏感度均>80%。结论T淋巴细胞亚群表达状态是影响EGFR突变型NSCLC患者埃克替尼治疗效果的临床因素之一,其中CD4+T细胞的表达情况可较好地预测疗效,高表达者可获得较好的临床获益。
Objective To investigate the influencing factors and predictive indicators for efficacy of Icotinib in epidermal growth factor receptor(EGFR)-mutant non-small cell lung cancer(NSCLC). Methods Sixty-four patients with EGFR-mutant NSCLC were enrolled,and all were treated with Icotinib.The incidence of adverse reactions and drug-resistance during treatment was assessed.The therapeutic efficacy was compared between patients with different clinical features,Cox regression model was used to analyze the factors influencing the therapeutic efficacy of Icotinib,and receiver operating characteristic(ROC) curve was employed to analyze the value of relevant indicators for predicting the therapeutic efficacy of Icotinib. Results Primary drug-resistance,local drug-resistance and chronic drug-resistance were found in 6(9.4%) cases,8(12.5%) cases and 45(70.3%) cases,respectively,and only mild adverse reactions occurred.The pretherapeutic CD3^+T cell proportion,CD4^+T cell proportion,and ratio of CD4^+/CD8^+T cells were the factors influencing the therapeutic efficacy of Icotinib (all P <0.05).For predicting the efficacy of Icotinib ,the area under ROC curve of CD4^+T cell proportion reached 0.819,and both specificity and sensitivity were higher than 80%. Conclusion In patients with EGFR-mutant NSCLC,the expression of T lymphocyte subsets is one of the clinical factors influencing the therapeutic efficacy of Icotinib, the expression of CD4^+T cell might achieve a better prediction for efficacy,and patients with high expression of CD4^+T cell might obtain a superior clinical benefit.
作者
王超
张九进
WANG Chao;ZHANG Jiu-jin(Department of Respiratory and Critical Care Medicine,the First People′s Hospital of Yulin City,Yulin 537000,China)
出处
《广西医学》
CAS
2019年第14期1758-1762,1766,共6页
Guangxi Medical Journal
基金
广西玉林市科学研究与技术开发计划(玉市科计20161617)
关键词
非小细胞肺癌
表皮生长因子受体
突变型
埃克替尼
临床疗效
影响因素
预测
Non-small cell lung cancer
Epidermal growth factor receptor
Mutation
Clinical feature
Influencing factor
Prediction
