文章摘要
张萍,唐敏,聂鑫,李琳.间变性淋巴瘤激酶阳性肺腺癌晚期患者的临床特征[J].中国临床保健杂志,2019,22(4):508-511.
间变性淋巴瘤激酶阳性肺腺癌晚期患者的临床特征
Clinical characteristics associated with advanced lung adenocarcinoma patients harboring ALK rearrangements
投稿时间:2019-02-26  
DOI:10.3969/J.issn.1672-6790.2019.04.020
中文关键词: 肺肿瘤  基因融合  肿瘤转移  疾病特征
英文关键词: Lung neoplasms  Gene fusion  Neoplasm metastasis  Disease attributes 〖FL
基金项目:中央保健局课题资助(W2016ZD01)
作者单位E-mail
张萍 北京医院肿瘤内科 国家老年医学中心,北京 100730 zhangping990721@126.com 
唐敏 北京医院肿瘤内科 国家老年医学中心,北京 100730  
聂鑫 北京医院肿瘤内科 国家老年医学中心,北京 100730  
李琳 北京医院肿瘤内科 国家老年医学中心,北京 100730 lilin_51@hotmail.com 
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中文摘要:
      目的 分析晚期肺腺癌间变性淋巴瘤激酶(ALK)基因融合患者临床特点。方法 收集经组织病理学证实的晚期或局部晚期不能手术的410例肺腺癌患者临床资料,患者均经过增强免疫组织化学(V-IHC)方法检测ALK融合基因表达状态。同时记录患者性别、年龄、初诊时转移部位,ARMs法检测的EGFR基因突变情况等基本资料,总结分析ALK基因融合患者的临床特点,为筛选非小细胞细胞肺癌ALK阳性患者及个体化治疗提供依据。结果 410例晚期肺腺癌患者中Ventana-IHC显示35例ALK阳性,阳性率为8.5%(35/410),同时检测的EGFR突变阳性患者为201例,突变率为49.0%(201/410),ALK基因融合发生率在EGFR阴性肺腺癌患者中占16.7%(35/209)。本组ALK阳性患者年龄在29~78岁,中位年龄52岁;男性15例,女性20例;初发时脑转移6例,肝转移7例,肾转移2例,腹膜转移2例;一线经含培美曲塞化疗18例,其中15例进入二线克唑替尼治疗,克唑替尼有效率46.7%,无进展生存期(PFS) 6.2月;一线克唑替尼治疗17例,有效率63.3%,PFS 10.8月。结论 晚期肺腺癌患者ALK基因融合是继EGFR基因突变后的又一驱动基因,其临床发病年龄更轻,更容易出现脑、肝和肾等部位的转移。
英文摘要:
      Objective To summarize the clinical characteristics of the patients with advanced lung adenocarcinoma and anaplastic lymphoma kinase (ALK) fusion gene.Methods Clinical data from the hospital for 410 advanced or inoperable locally advanced lung adenocarcinoma patients were collected,all patients were confirmed by histopathology examination.The patients were all exanimated by immunohistochemistry (V-IHC) method for the detection of ALK fusion gene expression status.Gender,age,newly diagnosed transferred place,EGFR gene mutation status by ARMs detection and other basic information were collected at the same time.Results 35 cases showed ALK positive within 410 patients with primary lung adenocarcinoma,the positive rate was 8.5% (35/410).201 cases were EGFR gene mutation with mutation rate 49.0% (201/410).The incidence rate was 16.7% (35/209) for ALK fusion gene within the EGFR negative patients with lung adenocarcinoma.The ALK positive patients were 29-78 years old and the median age was 52 years with 15 males and 20 females.There were 6 cases of brain metastases,7 cases of liver metastases,2 cases of renal metastases and 2 cases of peritoneal metastasis at the initial stage.18 cases were treated in chemotherapy by first-line drug of pemetrexed,including 15 cases treating by the second-line drug of crizotinib.The effective rate of crizotinib was 46.7% and PFS was 6.2 months.17 cases were treated by first-line drug of crizotinib with the effective rate 63.3% and PFS 10.8 months.Conclusion ALK fusion gene is a new driven gene for advanced lung adenocarcinoma besides EGFR gene mutation.Its clinical onset age is young and easy to metastasize into brain,liver,kidney and other parts.
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