原发性肝癌患者外周血KRAS基因水平及其对西妥昔单克隆抗体治疗疗效的影响

doi:10.3969/j.issn.1672-5069.2019.04.029

摘要/Abstract

摘要： 目的观察应用表皮生长因子受体（EGFR）靶向药物西妥昔单克隆抗体（C225）治疗原发性肝癌（PLC）患者的临床疗效及其影响疗效的因素。方法 2014年8月~2017年8月我院收治的96例PLC患者,在吉西他滨和顺铂化疗的基础上给予C225治疗。采用PCR法检测外周血KRAS基因突变。采用Logistic单因素和多因素回归分析影响疗效的独立因素。结果在治疗8 w末,在96例PLC患者中,PR 59例（61.5%）,SD 22例（22.9%）,PD 15例（15.6%）;在PR/SD组,血KRAS突变率为9.9%,显著低于PD组的40.0%（P<0.05）;PD组GGT-GAT、GGT-GTT和GGC-GAC突变率分别为13.3%、6.7%和6.7%,显著高于PR/SD组的0.0%、0.0%和0.0%（P<0.05）;多因素Logistic回归分析显示,除肝功能Child分级和肿瘤类型外,PKRAS基因突变亦为C225治疗PLC患者疗效的独立影响因素（P<0.05）。结论 EGFR靶向药物C225治疗晚期PLC患者有一定的疗效,检测血KRAS基因突变对选择患者和判断疗效可能有帮助。

关键词: 原发性肝癌, 西妥昔单克隆抗体, KRAS基因, 治疗

Abstract: Objective The aim of this study is to investigate the efficacyof cetuximab and KRAS gene mutation in the treatment of patients with primary liver cancer （PLC）.Methods A prospective study was conducted in 96 patients with PLC in our hospital from August 2014 to August 2017. All patients were treated with cisplatin,and the mutation of peripheral blood KRAS gene was detected by PCR. Logistic regression analysis was applied to find affecting efficacy factors.Results At the end of eight weeks,partial response （PR） was obtained in 59 （61.5%）,stable disease （SD） in 22 （22.9%）,and progressive diseases （PD） in 15（15.6%） patients with PLC;the blood KRAS mutation rate in 81 patients with PR/SD was 9.9%,much lower than 40.0% （P<0.05） in 15 patients with PD;the GGT-GAT and GGT-GTT mutation of condon 12 and GGC-GAC mutation of condon 13 in patients with PD were 13.3%,6.7% and 6.7%,significantly higher than 0.0%,0.0% and 0.0% （P<0.05） in patients with PR/SD;Logistic regression analysis showed that Child class,tumor type and PKRAS gene mutation were the independent factors affecting the efficacy. Conclusion The application of cetuximab in the treatment of patients with PLC might be efficacious,and the detection of blood KRAS gene mutation might be helpful for patient inclusion.

Key words: Hepatoma, Cetuximab, KRAS gene, Therapy

崔发强, 李涛, 王铮, 陈青. 原发性肝癌患者外周血KRAS基因水平及其对西妥昔单克隆抗体治疗疗效的影响[J]. 实用肝脏病杂志, 2019, 22(4): 565-568.

Cui Faqiang, Li Tao, Wang Zheng, et al. A pilot study on cetuximab and KRAS gene mutation in treatment of patients with primary liver cancer[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(4): 565-568.

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