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    刘海涛, 李陆风, 李殿明, 刘佳慧. PIK3CA对埃克替尼治疗EGFR基因突变的非小细胞肺癌病人的疗效预测[J]. 蚌埠医科大学学报, 2019, 44(8): 1015-1019. DOI: 10.13898/j.cnki.issn.1000-2200.2019.08.010
    引用本文: 刘海涛, 李陆风, 李殿明, 刘佳慧. PIK3CA对埃克替尼治疗EGFR基因突变的非小细胞肺癌病人的疗效预测[J]. 蚌埠医科大学学报, 2019, 44(8): 1015-1019. DOI: 10.13898/j.cnki.issn.1000-2200.2019.08.010
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    LIU Hai-tao, LI Lu-feng, LI Dian-ming, LIU Jia-hui. Predicting the efficacy of taking icotinib in the non-small cell lung cancer patients with EGFR gene mutation by PIK3CA[J]. Journal of Bengbu Medical University, 2019, 44(8): 1015-1019. DOI: 10.13898/j.cnki.issn.1000-2200.2019.08.010
    Citation: LIU Hai-tao, LI Lu-feng, LI Dian-ming, LIU Jia-hui. Predicting the efficacy of taking icotinib in the non-small cell lung cancer patients with EGFR gene mutation by PIK3CA[J]. Journal of Bengbu Medical University, 2019, 44(8): 1015-1019. DOI: 10.13898/j.cnki.issn.1000-2200.2019.08.010
    shu

    PIK3CA对埃克替尼治疗EGFR基因突变的非小细胞肺癌病人的疗效预测

    Predicting the efficacy of taking icotinib in the non-small cell lung cancer patients with EGFR gene mutation by PIK3CA

      摘要
    • 摘要:
      目的探讨PIK3CA对埃克替尼治疗EGFR基因突变的非小细胞癌（NSCLC）病人疗效预测价值。
      方法首先应用ARMS法对确诊肺腺癌标本给予EGFR基因突变检测。对于EGFR检测阳性肺腺癌标本应用免疫组化蛋白定性法进行PIK3CA表达状态分析。对EGFR检测阳性者给予埃克替尼治疗，观察PIK3CA高表达组与低表达组埃克替尼治疗后的无进展生存期（PFS）。
      结果在62例EGFR突变的肺癌病人中，48.38%同时存在PIK3CA高表达。在PIK3CA表达阳性病人应用埃克替尼后中位疾病PFS 10.5个月（95% CI：5.6~15.4）；PIK3CA表达阴性的病人应用埃克替尼后中位疾病PFS 17.0个月（95% CI：10.1~23.8）。PIK3CA低表达病人用埃克替尼治疗的应答率、中位PFS、EGFR-TKIs耐药率均有较高的趋势（χ2=7.16，P < 0.05）。
      结论在EGFR突变的接受埃克替尼治疗的NSCLC病人，检测PIK3CA表达状态有助于鉴别出EGFR-TKIs治疗有效较低的病人，提前进行干预，从而延长病人中位PFS。

       

      Abstract:
      ObjectiveTo investigate the usage of PIK3CA in predicting the efficacy of taking icotinib in the non-small cell lung cancer (NSCLC) patients with EGFR gene mutation.
      MethodsFirst, the ARMS method was used to detect the mutation of EGFR gene in the specimens of lung adenocarcinoma.Then, for EGFR-positive lung adenocarcinoma specimens, immunohistochemistry was used to analyze the expression status of PIK3CA.After that, icotinib was given to EGFR-positive patients, and progression-free survival (PFS) was observed for patients with high-expression PIK3CA and low-expression PIK3CA.
      ResultsAmong 62 lung cancer patients with EGFR mutation, 48.38% had high expression of PIK3CA.After applying icotinib in PIK3CA-positive patients, the median disease progression-free survival period reached 10.5 months(95% CI:5.6-15.4), and the median disease progression-free survival period for PIK3CA-negative patients taking icotinib was 17.0 months (95% CI:10.1-23.8).The response rate, median PFS, and EGFR-TKIs resistance rates of patients with low expression of PIK3CA increased significantly after taking icotinib, and the differences were significant(χ2=7.16, P < 0.05).
      ConclusionsFor the NSCLC patients who have received EGFR-TKIs treatment, the detection of the expression status of PIK3CA can help to identify the patients with low efficacy, so early intervention can be adopted to extend the PFS.

       

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