摘要
目的 探究EGFR ctDNA、肿瘤突变负荷(TMB)水平及循环肿瘤细胞(TMB)水平及循环肿瘤细胞(CTCs)计数在EGFR/TP53突变非小细胞肺癌中的临床价值。方法 纳入2021年2月至2023年2月秦皇岛市第一医院EGFR合并TP53突变晚期NSCLC患者60例及良性肺病对照30例,比较治疗前、治疗后EGFR ctDNA、TMB、CTCs差异;分析其与临床特征关系;随访2年,比较治疗后不同EGFR ctDNA、TMB、CTCs水平患者的生存情况。结果 患者组基线EGFR ctDNA、TMB、CTCs均高于对照,差异有统计学意义(P<0.05)。男性、肿瘤直径>3 cm及有淋巴结转移者CTCs更高,<60岁者EGFR ctDNA更高,差异有统计学意义(P<0.05);TMB在上述分层中比较差异无统计学意义(P>0.05)。治疗后EGFR ctDNA、CTCs、TMB较基线下降,差异有统计学意义(P<0.05)。2年随访显示:TMB≤7个/Mb者生存率高于>7个/Mb者,CTCs≤3个者高于>3个者,不同水平EGFR ctDNA患者的生存率比较差异无统计学意义(P=0.792)。结论 较低水平的TMB与CTCs与EGFR/TP53突变非小细胞肺癌更佳远期结局相关;EGFR ctDNA与2年生存情况未见显著关联。
Objective To investigate the clinical significance of EGFR circulating tumor DNA(ctDNA),tumor mutational burden(TMB),and circulating tumor cells(CTCs)in non⁃small cell lung cancer(NSCLC)harboring concurrent EGFR and TP53 mutations.Methods A total of 60 patients with EGFR com⁃bined with TP53 mutation advanced NSCLC and 30 patients with benign lung disease were included in Qin⁃huangdao First Hospital from February 2021 to February 2023 EGFR ctDNA,TMB,and CTC levels were com⁃pared before and after treatment.Associations with clinicopathological characteristics were examined,and pa⁃tients were followed for two years to assess survival according to post⁃treatment biomarker levels.Results At baseline,ctDNA,TMB,and CTCs were significantly elevated in NSCLC patients compared with controls(P<0.05).Higher CTC counts were observed in males,tumors>3 cm,and cases with nodal metastasis;ctDNA was higher in patients<60 years old(P<0.05).TMB did not differ significantly across these subgroups(P>0.05).All three biomarkers declined after therapy(P<0.05).During follow⁃up,patients with TMB≤7/Mb or CTCs≤3 had superior survival compared with those with higher levels(P<0.05),whereas ctDNA showed no significant association with two⁃year survival(P=0.792).Conclusion Lower TMB and reduced CTC counts are linked with more favorable long⁃term outcomes in EGFR/TP53⁃mutant NSCLC,while EGFR ctDNA is not predictive of two⁃year survival.
作者
于晓麟
华海侠
张丹
白洁
YU Xiaolin;HUA Haixia;ZHANG Dan;BAI Jie(Department of Radiotherapy,Qinhuangdao First Hospital,Qinhuangdao,Hebei 066000)
出处
《分子诊断与治疗杂志》
2025年第9期1756-1759,共4页
Journal of Molecular Diagnostics and Therapy
基金
河北省医学科学研究重点课题计划项目(20181185)。
