实用医学杂志 ›› 2022, Vol. 38 ›› Issue (14): 1804-1808.doi: 10.3969/j.issn.1006⁃5725.2022.14.017

• 临床研究 • 上一篇    下一篇

肿瘤突变负荷水平在非小细胞肺癌患者术后接受铂类药物为基础辅助化疗的临床意义

李静1 李宝重2 郭现利3 郭军梅4    

  1. 1 解放军总医院第五医学中心肿瘤医学部(北京 100071);2 北京世纪坛医院胸外科(北京 100038); 3 解放军总医院第八医学中心呼吸与危重症二区(北京 100091);4 内蒙古医科大学附属人民医院放疗科 (呼和浩特 010020)

  • 出版日期:2022-07-25 发布日期:2022-07-25
  • 通讯作者: 郭现利 E⁃mail:jijiuzhanshi@126.com
  • 基金资助:
    内蒙古自治区科技计划项目(编号:2019GG086)

The clinical significance of TMB in patients with NSCLC receiving platinum⁃based adjuvant chemotherapy

LI Jing*,LI Baozhong,GUO Xianli,GUO Junmei.    

  1. Chinese PLA General Hospital,Beijing 100071,China 

  • Online:2022-07-25 Published:2022-07-25
  • Contact: GUO Xianli E⁃mail:jijiuzhanshi@126.com

摘要:

目的 探讨肿瘤突变负荷(TMB)在接受铂类药物为基础辅助化疗的非小细胞肺癌(non⁃ small cell lung cancer,NSCLC)患者中的临床意义。方法 研究纳入78例术后接受铂类药物为基础辅助化 疗的非鳞 NSCLC 患者。通过二代测序技术进行体细胞突变检测和 TMB 分析。随后通过电话随访获取 患者的复发情况和长期生存数据。进行 TMB 状态和预后的生存分析,并通过 Cox 多变量分析进行校正。 结果 78 NSCLC 患者中最常见的突变基因为 TP53、EGFR、LRP1B、DNMT3A FAT3。此外,以中位 TMB 值为阈值将患者分为低 TMB 组和高 TMB 组。关联分析表明高 TMB 患者的 OS 较差。此外,Cox 多变 量分析结果提示 TMB 对患者的 OS 仍具有独立的影响。结论 TMB 对术后接受铂类药物为基础辅助化 疗的非鳞NSCLC 患者的OS 具有较差的影响。

关键词:

非小细胞肺癌, 铂类药物, 辅助化疗, 肿瘤突变负荷, 预后

Abstract:

Objective To investigate the clinical significance of TMB for patients with NSCLC who received platinum⁃based adjuvant chemotherapy. Methods A total of 78 patients with non⁃squamous NSCLC who received platinum⁃based adjuvant chemotherapy were included in this study. Somatic mutation detection and TMB analysis were performed using next⁃generation sequencing. The data on recurrence and long⁃term survival in the patients was obtained by telephone follow⁃up. Survival analysis between TMB and prognosis was performed and then adjusted by multivariate Cox regression. Results The most common somatic mutation genes were TP53,EGFR, LRP1B,DNMT3A and FAT3 in the 78 patients. The patients were assigned to TMB ⁃ L group or TMB ⁃ H group based on the median TMB threshold. Association analysis indicated that patients with TMB ⁃H had a poorer OS. Besides,multivariate Cox analysis suggested that TMB was an independent factor for OS. Conclusions Higher TMB status had an adverse impact on OS in the patients with non⁃squamous NSCLC who received platinum⁃based adjuvant chemotherapy. And these research findings should be further verified by prospective studies. 

Key words:

non ? small cell lung cancer, platinum drugs, adjuvant chemotherapy, tumor mutation burden, prognosis