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Lung cancer is the most common malignant tumor worldwide. There are more than 700000 new cases diagnosed as lung cancer each year in China, of which 80％-85％ are non-small cell lung cancer (NSCLC). The mutation proportion of epidermal growth factor receptor (EGFR) may reach up to 40％-55％. EGFR-tyrosine kinase inhibitor (EGFR-TKI) has become the standard first-line treatment method for advanced NSCLC patients with EGFR mutation. Chinese oncologists have done a large number of clinical studies, providing an important evidence-based medicine proof for treatment of advanced NSCLC with EGFR mutation.
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Objective To investigate the value of detecting peripheral blood epidermal growth factor receptor (EGFR) gene in predicting the therapeutic efficacy of advanced non-small cell lung cancer. Methods A total of 150 patients with stage ⅢA-Ⅳ non-small cell lung cancer diagnosed in Shanxi Provincial Cancer Hospital from October 2013 to February 2015 were collected. The peripheral blood EGFR gene was detected by amplification refractory mutation system (ARMS). The relationship between the mutation rate and the clinicopathological features of patients was observed, and 80 patients were selected into the follow-up treatment according to the inclusion criteria. Forty patients (all 19 or 21 exon mutations) in group A with EGFR gene mutation were treated with gefitinib orally. Forty patients with wild type EGFR gene in group B underwent 4 cycles of NP regimen. Efficacy and progression-free survival were evaluated in both groups. Results The mutation rate of EGFR gene was 33.3 ％ (50 cases), of which 29 were exon 19, 18 were exon 21 and 3 were exon 18 and 20. The mutation rate of EGFR gene was higher in female, adenocarcinoma and non-smoker (all P<0.05). Among the 80 patients who received follow-up treatment, the effective rate [67.5％(27/40) vs. 32.5 ％ (13/40)] and disease control rate [85.0 ％ (34/40) vs. 65.0 ％ (26/40)] in group A were significantly higher than those in group B, and the median PFS was prolonged (9.00 months vs. 4.25 months),the differences were statistically significant (χ2=9.800, P=0.002;χ2=4.267, P=0.039;χ2= 15.792, P<0.001). Conclusion The detection of peripheral blood EGFR mutation can be used to predict the efficacy of tyrosine kinase inhibitors in non-small cell lung cancer.
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Objective To evaluate the efficacy and drug-related toxicities of pemetrexed disodium in the treatment of advanced pulmonary adenocarcinoma.Methods A total of 41 patients who had received pemetrexed disodium and cisplatin therapy were retrospectively reviewed.The patients were given respectively pemetrexed disodium (500 mg/m2,1st day) and cisplatin (200 mg/m2,1-4 day) until disease progressed.The clinical outcomes and adverse reactions were observed.Results The CR rate was 7.3 ％ (3/41),PR rate was 22.0 ％ (9/41),SD rate was 31.7 ％ (13/41),PD rate was 39.0 ％ (16/41),the DRR was 29.3 ％ (12/41),DCR rate was 61.0 ％ (25/41),the median PFS was 5 months.The age,sex,smoking history,staging and timing of treatment had not the statistics difference on ORR and DCR.The sex,smoking history,staging and timing of treatment had not the statistical difference on PFS (P ＞ 0.05).The main toxicities were fatigue,nausea,vomiting and myelosuppression.Conclusion The pemetrexed disodium and cisplatin are feasible and welltolerated for advanced pulmonary adenocarcinoma patients.
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Objective To test serum differentially expressed proteins between early-stage (stage IB-ⅢA) and late-stage (stage Ⅳ) lung cancer patients by proteinchip technology and investigate its clinical value. Methods SELDI-TOF-MS and WCX-2 protein chip were used to detect the serum protein of 30 cases of early stage lung cancer patients and 30 cases of late stage lung cancer patients. The data were analyzed by using Biomarker Wizard software. Results There are ten different proteins in the serum between the two groups of lung cancer patients. Four protein markers 7978, 8139, 15 951 and 16 133 are over expressed and seven protein markers 2867, 6885, 8701, 8840, 13 781 and 13 955 are low expressed in the late group. Conclusion SELDI-TOF-MS proteinchip technology is a convenient, sensitive and high-throughput analysis method which can screen several relatively specific protein markers for late stage lung cancer from the serum samples. This selected protein markers can predict metastasis of lung cancer patients.
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Objective To study the relationship between expression of matrix metalloproteinases-7 (MMP-7) and clinicopathological characteristics in patients with primary non-smaU cell lung cancer(NSCLC). Methods MMP-7 in 20 normal people and 60 advanced NSCLC patiens were detected with reverse-transcription-polymerase-chain-reaction. Gelatum image analysator analyzed the result. Results The amount of MMP-7 was less in normal people (30.000) than in NSCLC patients(41.231) significantly(P<0.05); the level of MMP-7 was no correlated with gender, age, pathology pattern, tumor size, was inverse correlation with differentiation, and was positive correlation with clinical stages(P <0.05). Conclusion The level of MMP-7 is closely correlated with tissue differentiation and clinical stages of NSCLC, which may serve as a parameter for determining tumor invasion and metastatic.