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EGFR 突变型转移性肺腺癌的预后因素。

Prognostic factors of EGFR-mutated metastatic adenocarcinoma of lung.

机构信息

Nuclear Medicine Unit and Clinical PET Centre, Queen Elizabeth Hospital, Hong Kong, PR China.

Nuclear Medicine Unit and Clinical PET Centre, Queen Elizabeth Hospital, Hong Kong, PR China.

出版信息

Eur J Radiol. 2020 Feb;123:108780. doi: 10.1016/j.ejrad.2019.108780. Epub 2019 Dec 10.

Abstract

PURPOSE

The first-line treatment of metastatic lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutation is tyrosine kinase inhibitor (TKI). This study aimed to evaluate potential factors affecting the progression-free survival under TKI treatment.

METHODS

Forty one patients with EGFR-mutated metastatic lung adenocarcinoma under first-line TKI treatment were retrospectively evaluated. Ten factors potentially influencing the progression-free survival were studied: patients' age, gender, smoking history, number of comorbidities, performance status, tumor mutation site, maximum of standardized uptake value (SUV) of primary tumor in FDG PET/CT, serum CEA level, number of metastatic organs and presence of pleural/pericardial effusion. Mantel-Cox tests and waterfall plots were performed for statistical analyses.

RESULTS

Statistical evaluation demonstrated that primary SUV, serum CEA level, gender and smoking history were important prognostic factors, with corresponding p values of 0.001, 0.023, 0.034 and 0.041 respectively in Mantel-Cox analyses.

CONCLUSION

Low primary SUV, low serum CEA level, female and never smoker were four prognostic factors suggestive of good response to TKI in mutated EGFR metastatic lung adenocarcinoma. SUV is probably the most important among the four factors.

摘要

目的

表皮生长因子受体(EGFR)突变型转移性肺腺癌的一线治疗方法是酪氨酸激酶抑制剂(TKI)。本研究旨在评估 TKI 治疗下影响无进展生存期的潜在因素。

方法

回顾性评估了 41 例接受一线 TKI 治疗的 EGFR 突变型转移性肺腺癌患者。研究了 10 个可能影响无进展生存期的因素:患者年龄、性别、吸烟史、合并症数量、体能状态、肿瘤突变部位、FDG PET/CT 中原发肿瘤的最大标准化摄取值(SUV)、血清 CEA 水平、转移器官数量以及胸腔/心包积液的存在。进行了 Mantel-Cox 检验和瀑布图进行统计分析。

结果

统计评估表明,原发 SUV、血清 CEA 水平、性别和吸烟史是重要的预后因素,Mantel-Cox 分析的相应 p 值分别为 0.001、0.023、0.034 和 0.041。

结论

低原发 SUV、低血清 CEA 水平、女性和从不吸烟者是 EGFR 突变型转移性肺腺癌对 TKI 反应良好的四个预后因素。SUV 可能是这四个因素中最重要的一个。

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