摘要
目的探讨KRAS/PIK3CA、TP53/PIK3CA共突变对晚期非小细胞肺癌(NSCLC)预后的影响。方法选取郑州大学第一附属医院收治的66例初治晚期NSCLC患者,根据基因突变分成KRAS/PIK3CA(KI组)、TP53/PIK3CA(TI组)等2组,根据治疗方式分成化疗和免疫治疗。其中KI组化疗21例,免疫治疗12例,TI组化疗19例,免疫治疗14例。比较2组化疗和免疫治疗的临床疗效,采用多因素COX回归模型分析预后影响因素。结果KI组免疫治疗的疾病控制率(DCR)(83.33%)高于同组化疗(23.81%),同时高于TI组免疫治疗(28.57%),差异均有统计学意义(χ^(2)=8.644,P=0.003;χ^(2)=10.437,P=0.008)。KI组和TI组化疗的疾病无进展生存期(PFS)分别为3.98个月和3.83个月,免疫治疗的PFS分别为9.00个月和6.30个月,免疫治疗均较化疗偏高,差异均有统计学意义(χ^(2)=24.561,P<0.001;χ^(2)=15.654,P<0.001);KI组免疫治疗的PFS较TI组偏高,差异有统计学意义(χ^(2)=16.077,P<0.001);KI组化疗的PFS与TI组比较差异无统计学意义(χ^(2)=0.187,P=0.773)。多因素COX模型结果显示,KRAS/PIK3CA突变和免疫治疗为延长PFS独立影响因素(P=0.001;P<0.001)。结论KRAS/PIK3CA和TP53/PIK3CA共突变免疫治疗预后较化疗好,KRAS/PIK3CA突变免疫治疗的预后较TP53/PIK3CA突变好,且KRAS/PIK3CA、免疫治疗是晚期NSCLC预后的独立保护性因素。
Objective To explored the effects of co-mutations of KRAS/PIK3CA and TP53/PIK3CA on the prognosis of advanced non-small cell lung cancer(NSCLC).Methods All the 66 patients with advanced NSCLC who were treated in the First Affiliated Hospital of Zhengzhou University were selected.According to gene co-mutation,KRAS/PIK3CA(the KI group)and TP53/PIK3CA(the TI group)were divided into chemotherapy and immunotherapy according to treatment mode.Among them,21 patients received chemotherapy and 12 patients received immunotherapy in the KI group,19 patients received chemotherapy and 14 patients received immunotherapy in the TI group.The clinical efficacy of chemotherapy and immunotherapy was compared between the two groups,and the prognostic factors were analyzed by multivariate COX model.Results The disease control rate(DCR)of immunotherapy in the KI group(83.33%)was higher than that of chemotherapy(23.81%),DCR of immunotherapy in the KI group was higher than that of immunotherapy in the TI group(28.57%),the differences were statistically significant(χ^(2)=8.644,P=0.003;χ^(2)=10.437,P=0.008).The progression free survival(PFS)of the KI group and the TI group were 3.98 and 3.83 months for chemotherapy,and 9.00 and 6.30 months for immunotherapy,respectively.Immunotherapy was higher than chemotherapy in both groups,and the differences were statistically significant(χ^(2)=24.561,P<0.001;χ^(2)=15.654,P<0.001).The PFS of immunotherapy in the KI group was statistically higher than that in the TI group(χ^(2)=16.077,P<0.001).The PFS of chemotherapy in the two groups were similar(χ^(2)=0.187,P=0.773).The results of multivariate COX model showed that KRAS/PIK3CA mutation and immunotherapy were the independent influencing factors for prolonging PFS(P=0.001;P<0.001).Conclusion The prognosis of KRAS/PIK3CA and TP53/PIK3CA co-mutation immunotherapy is better than chemotherapy,and the prognosis of KRAS/PIK3CA mutation immunotherapy is better than TP53/PIK3CA mutation,and KRAS/PIK3CA and immunotherapy are independent protective factor
作者
张莉莉
杨双宁
王丽萍
ZHANG Lili;YANG Shuangning;WANG Liping(Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《肿瘤基础与临床》
2022年第3期227-230,共4页
journal of basic and clinical oncology
基金
国家自然科学基金资助项目(81872410)。
