Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China.
Department of Radiotherapy, Xianyang Hospital, Yanan University, Xianyang, Shaanxi 712000, P.R. China.
Mol Med Rep. 2018 Jun;17(6):7575-7584. doi: 10.3892/mmr.2018.8859. Epub 2018 Apr 5.
Research has identified that epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) possess large benefits for adenocarcinoma (ADC), although little benefit for squamous cell carcinoma (SCC). The aim of the present study was to investigate the percentage of patients with SCC with the EGFR mutations subset and the benefits of EGFR TKIs in SCC. In the present study, the EGFR mutations subset was detected with an amplification refractory mutation system in 1,359 clinical SCC tissues. The association of the EGFR mutations subset with clinicopathological parameters was evaluated using the Mann‑Whitney U test, and Kruskal‑Wallis H. Kaplan‑Meier survival analysis was used to estimate the effect of the EGFR mutations subset on SCC patient survival rates. A total of 94 out of 1,359 SCC patients were identified as having EGFR mutations, an EGFR mutation rate of 6.92%. The EGFR mutations subset in the 94 cases was identified as follows: 37.2% (35/94) in exon 19; 39.4% (37/94) in L858R; 5.3% (5/94) in T790M; 4.3% (4/94) in G719X; 2.1% (2/94) in L861Q; and 11.7% (11/94) in other mutations. Kaplan‑Meier survival analysis identified that the differentiation, pathological tumor, node, metastasis stage, lymph node metastasis and distant metastases were significantly associated with patients' survival (P>0.05; log‑rank test), and no significant difference was observed between TKI therapy and chemotherapy in terms of patient survival rates (P>0.05). In addition, the overall discordant rate of the EGFR mutations subset in SCC patients was relatively low. Due to the non‑significant difference between TKI therapy and chemotherapy in terms of patient survival and the lower discordance rate of the EGFR mutations subset in SCC patients, EGFR TKIs could be a recommended treatment for SCC.
研究已经确定,表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKI)对腺癌(ADC)有很大的益处,尽管对鳞状细胞癌(SCC)的益处较小。本研究的目的是探讨 SCC 中 EGFR 突变亚组的患者比例以及 EGFR TKI 在 SCC 中的获益。本研究采用扩增阻滞突变系统检测了 1359 例临床 SCC 组织中的 EGFR 突变亚组。采用 Mann-Whitney U 检验评估 EGFR 突变亚组与临床病理参数的相关性,采用 Kaplan-Meier 生存分析估计 EGFR 突变亚组对 SCC 患者生存率的影响。在 1359 例 SCC 患者中,共发现 94 例存在 EGFR 突变,EGFR 突变率为 6.92%。94 例患者的 EGFR 突变亚组如下:19 外显子缺失 37.2%(35/94);L858R 突变 39.4%(37/94);T790M 突变 5.3%(5/94);G719X 突变 4.3%(4/94);L861Q 突变 2.1%(2/94);其他突变 11.7%(11/94)。Kaplan-Meier 生存分析发现,分化、病理肿瘤、淋巴结、转移分期、淋巴结转移和远处转移与患者的生存显著相关(P>0.05;log-rank 检验),而 TKI 治疗与化疗在患者生存率方面无显著差异(P>0.05)。此外,SCC 患者 EGFR 突变亚组的总不一致率相对较低。由于 TKI 治疗与化疗在患者生存方面无显著差异,以及 SCC 患者 EGFR 突变亚组的不一致率较低,EGFR TKI 可作为 SCC 的推荐治疗方法。