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三级医疗环境中晚期非小细胞肺癌患者的临床病理特征、表皮生长因子受体(EGFR)突变及间变性淋巴瘤激酶(ALK)重排与生存情况

Clinicopathological Features, Epidermal Growth Factor Receptor (EGFR) Mutations and Anaplastic Lymphoma Kinase (ALK) Rearrangement-Based Survival of Patients With Advanced Non-small Cell Lung Cancer in a Tertiary Care Setting.

作者信息

Bin Naeem Sameen, Tariq Zeeshan, Abbas Mansoor, Badar Farhana, Shahid Rameen, Hassan Sadia, Asif Farah

机构信息

Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.

Clinical Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.

出版信息

Cureus. 2024 Dec 23;16(12):e76257. doi: 10.7759/cureus.76257. eCollection 2024 Dec.

Abstract

Background Lung cancer is the most frequent cause of cancer-related deaths and the most common type of cancer globally. It is generally classified into two main histologic subtypes: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is the most prevalent type and is enriched with genetic and molecular diversity. This study evaluated the clinical, molecular, and demographic characteristics of patients with NSCLC, with a focus on variables involving disease stage, survival rates, and mutations in the epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) genes. Methods This retrospective study included 51 adult patients aged 30 years and older. Only patients who received treatment and subsequent follow-up at our institution were included in this study. Results There were 51 patients, aged 30-84 years (mean = 59.6 ± 10.9). Out of 51 patients, 32 (64.7%) were men; 19 (37.2.5%) were either current or former smokers; 34 patients (66.7%) had an Eastern Cooperative Oncology Group (ECOG) performance status of either 0 or 1; 47 (92.2) had an adenocarcinoma; 15 (29.4%) had a bilateral lung disease; 43 (84.3%) had stage IV disease; 10 (19.6%) had a positive EGFR status; eight (15.7) had a positive ALK status; and 38 patients (73.1%) had died by the cut-off date for this study. The median survival time for the EGFR-negative patients was 15 months, as opposed to 16 months for those who were EGFR-positive. Likewise, the median survival time for both the ALK-negative and positive patients was 17 months each. Conclusion The study contributes to our understanding of NSCLC and highlights the trends of our region while acknowledging the limitations associated with molecular studies and smaller sample sizes. These findings are not aligned with global trends in NSCLC due to the above-mentioned reasons. Future prospective trials are needed to aim for larger cohorts and consider additional variables to address the complexities of NSCLC.

摘要

背景

肺癌是癌症相关死亡的最常见原因,也是全球最常见的癌症类型。它通常分为两种主要的组织学亚型:非小细胞肺癌(NSCLC)和小细胞肺癌(SCLC)。NSCLC是最普遍的类型,具有丰富的遗传和分子多样性。本研究评估了NSCLC患者的临床、分子和人口统计学特征,重点关注涉及疾病分期、生存率以及表皮生长因子受体(EGFR)和间变性淋巴瘤激酶(ALK)基因的突变等变量。

方法

这项回顾性研究纳入了51名年龄在30岁及以上的成年患者。本研究仅纳入了在我们机构接受治疗及后续随访的患者。

结果

共有51名患者,年龄在30 - 84岁之间(平均 = 59.6 ± 10.9)。在51名患者中,32名(64.7%)为男性;19名(37.25%)为现吸烟者或既往吸烟者;34名患者(66.7%)的东部肿瘤协作组(ECOG)体能状态为0或1;47名(92.2%)患有腺癌;15名(29.4%)患有双侧肺部疾病;43名(84.3%)处于IV期疾病;10名(19.6%)EGFR状态为阳性;8名(15.7%)ALK状态为阳性;38名患者(73.1%)在本研究的截止日期前死亡。EGFR阴性患者的中位生存时间为15个月,而EGFR阳性患者为16个月。同样,ALK阴性和阳性患者的中位生存时间均为17个月。

结论

本研究有助于我们对NSCLC的理解,并突出了我们地区的趋势,同时承认分子研究和样本量较小所带来的局限性。由于上述原因,这些发现与NSCLC的全球趋势不一致。未来需要进行前瞻性试验,以针对更大的队列并考虑其他变量,以解决NSCLC的复杂性问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/291f/11753902/cb6cc49438bb/cureus-0016-00000076257-i01.jpg

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