文章摘要

非小细胞肺癌患者中HER2基因突变的临床特征及预后

作者: 1黄章洲, 2王文娴, 1庄武, 1黄韵坚, 3许春伟, 4方美玉, 5朱有才, 5杜开齐, 3陈刚
1 福建医科大学附属福建省肿瘤医院胸部肿瘤内科,福州 350014
2 浙江省肿瘤医院胸部肿瘤内科,杭州 310022
3 福建医科大学附属福建省肿瘤医院病理科,福州 350014
4 浙江省肿瘤医院综合肿瘤内科,杭州 310022
5 浙江省荣军医院胸部疾病诊疗中心,浙江 嘉兴 314000
通讯: 庄武 Email: aoshitianyi@126.com
DOI: 10.3978/j.issn.2095-6959.10.3978/j.issn.2095-6959.2017.09.015
基金: 国家临床重点专科建设项目, 2013 福建省科技厅引导性项目 2016Y0019, 2015Y0011 浙江省卫生科研计划基金, 2013KYB051 浙江省中医药局科研基金, 2013ZQ005 浙江省科技厅公益类科研计划, 2015C33194 吴阶平医学基金会临床科研资金项目, 20114272111 嘉兴市科技计划项目, 2016AY23087

摘要

目的:探讨非小细胞肺癌HER2基因突变的临床特征和预后。方法:回顾性分析15例HER2基因突变的非小细胞肺癌临床特征,Kaplan-Meier法计算生存率,log-rank法进行生存率显著性检验。结果:非小细胞肺癌中HER2基因突变率1.92%(15/781),女性患者突变率高于男性患者(3.76% vs 1.23%,P=0.022),吸烟患者突变率高于未吸烟患者(3.17% vs 0.74%,P=0.027),中位生存时间42.6个月,其中复合突变12例,中位生存时间42.6个月,单纯突变3例,中位生存时间40.3个月,两者差异无统计学意义(P=0.43);伴随EGFR基因突变8例,中位生存时间50.6个月,不伴随EGFR基因突变7例,中位生存时间42.6个月(P=0.19),伴随TP53基因突变9例,中位生存时间40.4个月,不伴随TP53基因突变6例,中位生存时间46.7个月(P=0.39),伴随SMARCA4基因突变2例,中位生存时间50.6个月,不伴随SMARCA4基因突变13例,中位生存时间42.6个月(P=0.33),伴随MTOR基因突变2例,中位生存时间44.3个月,不伴随MTOR基因突变13例,中位生存时间42.6个月(P=0.71),伴随APC基因突变2例,中位生存时间39.0个月,不伴随APC基因突变13例,中位生存时间42.6个月(P=0.92)。结论:非小细胞肺癌HER2基因突变在女性未吸烟患者中多见,伴随基因状态对HER2基因突变预后可能影响不大。
关键词: 非小细胞肺癌 HER2 临床特征 预后

Clinical features and prognosis of non-small cell lung cancer harboring HER2 mutations

Authors: 1HUANG Zhangzhou, 2WANG Wenxian, 1ZHUANG Wu, 1HUANG Yunjian, 3XU Chunwei, 4FANG Meiyu, 5ZHU Youcai, 5DU Kaiqi, 3CHEN Gang
1 Department of Medical Thoracic Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014
2 Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou 310022
3 Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014
4 Department of Comprehensive Medical Oncology, Zhejiang Cancer Hospital, Hangzhou 310022
5 Department of Chest Disease Diagnosis and Treatment Center, Zhejiang Rongjun Hospital, Jiaxing Zhejiang 314000, China

CorrespondingAuthor: ZHUANG Wu Email: aoshitianyi@126.com

DOI: 10.3978/j.issn.2095-6959.10.3978/j.issn.2095-6959.2017.09.015

Abstract

Objective: To investigate clinical features and prognosis of non-small cell lung cancer (NSCLC) harboring HER2 mutations. Methods: We retrospectively reviewed clinical features from 15 patients with NSCLC harboring HER2 mutations, and the survival rate was calculated by Kaplan-Meier method and log-rank test was used to compare the survival rates. Results: HER2 gene mutation rate was 1.92% (15/781) in non-small cell lung cancer, mutation rate of female was much higher than male (3.76% vs 1.23%, P=0.022), and current-smoker was much higher than no-smoker (3.17% vs 0.74%, P=0.027), the median overall survival time was 42.6 months, including 12 cases compound mutation, the median overall survival time for 42.6 months, 3 cases simple mutation, the median overall survival time for 40.3 months, but both no statistical difference (P=0.43), with EGFR mutations in 8 cases, the median overall survival time for 50.6 months, and without EGFR mutations in 7 cases, the median overall survival time for 42.6 months (P=0.19), with TP53 mutations in 9 cases, the median overall survival time for 40.4 months, and without TP53 mutations in 6 cases, the median overall survival time for 46.7 months (P=0.39), with SMARCA4 mutations in 2 cases, the median overall survival time for 50.6 months, and without SMARCA4 mutations in 13 cases, the median overall survival time for 42.6 months (P=0.33), with MTOR mutations in 2 cases, the median overall survival time for 44.3 months, and without MTOR mutations in 13 cases, the median overall survival time for 42.6 months (P=0.71), with APC mutations in 2 cases, the median overall survival time for 39.0 months, and without APC mutations in 13 cases, the median overall survival time for 42.6 months (P=0.92). Conclusion: There is some significant difference of clinical features in HER2 gene mutations with non-smoking women in non-small cell lung cancer, along with the state of HER2 gene mutations little influence on prognosis.
Keywords: non-small cell lung cance HER2 clinical features Prognosis