ISSN: 1859 - 2872
Mối liên quan giữa đột biến gen EGFR với nguy cơ di căn não ở bệnh nhân ung thư phổi không tế bào nhỏ: Kết quả từ nghiên cứu tiến cứu
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Keywords
Đột biến gen EGFR, ung thư phổi không tế bào nhỏ di căn não
Tóm tắt
Mục tiêu: Đánh giá mối liên quan giữa đột biến gen EGFR với nguy cơ di căn não ở bệnh nhân ung thư phổi không tế bào nhỏ (UTPKTBN). Đối tượng và phương pháp: Nghiên cứu tiến cứu, theo dõi dọc 213 bệnh nhân UTPKTBN giai đoạn I - IIIB được xét nghiệm đột biến gen EGFR từ năm 2014 đến 2020. Yếu tố nguy cơ được phân tích đa biến bằng phương trình hồi quy tuyến tính. Kết quả: Có 41,3% bệnh nhân xuất hiện di căn xa, trong đó di căn não 22,7%. Tỉ lệ đột biến gen EGFR dương tính là 27,2%, có 37,5% bệnh nhân di căn não mang đột biến gen EGFR, OR 2,89 (khoảng tin cậy 95%: 1,011 - 8,270), p=0,048. Bệnh nhân mang đột biến điểm L858R ở exon 21 có tỉ lệ di căn não 55,6% xu hướng cao hơn bệnh nhân mang đột biến xóa đoạn ở exon 19 (28,6%), nhưng sự khác biệt không có ý nghĩa thống kê (p>0,05). Không thấy yếu tố khác liên quan đến nguy cơ di căn não. Kết luận: Đột biến gen EGFR là một yếu tố làm tăng nguy cơ di căn não ở bệnh nhân ung thư phổi không tế bào nhỏ.
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11. Devarati M, Yu-Hui C, Richard L et al (2019) EGFR mutant locally advanced non-small cell lung cancer is at increased risk of brain metastasis. Clinical and Translational Radiation oncology 18: 32-38.
12. Dong-Yeop Shin, Im Il Na, Cheol Hyeon Kim et al (2014) EGFR mutation and brain metastasis in pulmonary adenocarcinomas. J Thorac Oncol 9: 195-199.
13. Wei-Yuan Chang, Yi-Lin Wu, Po-Lan Su et al (2018) The impact of EGFR mutations on the incidence and survival of stages I to III NSCLC patients with subsequent brain metastasis. Plos One 13(2): 0192161.
14. Kuilpers CCHJ, Hendriks LEL, Derks JL et al (2018) Association of molecular status and metastatic organs at diagnosis in patients with stage IV non squamous non-small cell lung cncer. Lung cancer 121: 76-81.
15. Tomohiro T, Koichi K, Kensuke N et al (2015) Speccific organ metastase and survival in metastatic non-small cell lung cancer. Molecular and clinical oncology 3: 217-221.
16. Carlos G, Saya J, Brian SF et al (2020) The role of EGFR mutations in predicting recurrence in early and locally advanced lung adenocarcinoma following definitive therapy. Oncotarget 11(21): 1953-1960.
17. Yuankai S, Joseph Siu-Kie A, Sumitra T et al (2014) A prospective, molecular epidemiology study of EGFR mutations in Asian patients with Advanced non-small cell lung cancer of adenocarcinoma hiaatology (PIONEER). Journal of Thoracic Oncology 9(2): 154-162.
18. Yue-Lun Zhang, Jin-Qiu Yuan, Kai-Feng Wang et al (2016) The prevalence of EGFR mutation in patients with non-small cell lung cancer: A systematic review and meta-analysis. Oncotarget 7(48): 78985-78993.
19. Can Pi, Chong-Rui Xu, Ming-feng Zhang et al (2018) EGFR mutations in early-stage and advanced-stage lung ademocarcinoma: Analysis based on large-scale data from China. Thoracic Cancer 9: 814-819.
20. Lina Li, Shuimei Luo, Heng Lin et al (2017), Corelation between EGFR mutation status and the incidence of brain metastaes in patients with non-small cell lung cancer. J Thorac Dis 9(8): 2510-2520.
21. Yuya Fujita, Manabu Kinoshita, Tomohiko Ozaki et al (2020) The impact of EGFR mutation status and single brain metastasis on the survival of non-small cell lung cancer patients with brain metastases. Neuro – Oncology Advances 2(1): 1-8.
2. NCCN Guideline Insights (2020) Non-small cell lung cancer. Version 3.2020, feature updates to the NCCN Guidelines.
3. Masaki H, Sun-Jin K, Isaiah JF et al (2014) The molecular biology of lung cancer brain metastasis: An overview of curent comprehensions and future perspectives. J.Med.Invest 61: 241-253.
4. Mao-hua Z, Hong-tao S, Ji-guang X et al (2016) Combining whole-brain radiotherapy with Gefitinib/Erlotinib for brain metastase from non-small cell lung cancer: A meta-analysis. BioMed Research International Volume 2016, Article ID 5807346.
5. Naoto A, Tsuneo S, Kazuhito M et al (2018) Comparison of the efficacies of the first-generation epidermal growth factor receptor tyrosine kinase inhibitors for brain metastasis in patients with advanced non-small cell lung cancer harboring EGFR mutations. BMC cancer 18: 1012.
6. Paz-Ares L, Tan EH, O’Byrne K et al (2017) Afatinib versus gefititnib in patients with EGFR mutation-positive advanced non-small cell lung cancer: overall survival data from the phase IIb LUX-LUNG 7 trial. Annals of Oncology 28: 270-277.
7. Soria JC, Ohe Y, Reungwetwattana T et al (2018) Osimetinib in Untreated EGFR-Mutated Advanced non-small cell lung cancer. The New England Journal of Medicine 378(2): 113-125.
8. Sally CM Lau, Ullas B, Tony SK Mok et al (2019) Dacomitinib in the management of advanced non-small cell lung cancer. Drugs 79(8): 823-831.
9. Fred H, Alex DC, David A et al (2016) EGFR mutation status on brain metastases from non-small cell lung cancer. Lung cancer 96: 101-107.
10. Vijaya RB, Sanyo D’Souza P, Lynette MS et al (2017) Pidermal Growth Factor Receptor mutations status and brain metastases in non-small cell lung cancer. Journal of Global Oncology 3(3): 208-217.
11. Devarati M, Yu-Hui C, Richard L et al (2019) EGFR mutant locally advanced non-small cell lung cancer is at increased risk of brain metastasis. Clinical and Translational Radiation oncology 18: 32-38.
12. Dong-Yeop Shin, Im Il Na, Cheol Hyeon Kim et al (2014) EGFR mutation and brain metastasis in pulmonary adenocarcinomas. J Thorac Oncol 9: 195-199.
13. Wei-Yuan Chang, Yi-Lin Wu, Po-Lan Su et al (2018) The impact of EGFR mutations on the incidence and survival of stages I to III NSCLC patients with subsequent brain metastasis. Plos One 13(2): 0192161.
14. Kuilpers CCHJ, Hendriks LEL, Derks JL et al (2018) Association of molecular status and metastatic organs at diagnosis in patients with stage IV non squamous non-small cell lung cncer. Lung cancer 121: 76-81.
15. Tomohiro T, Koichi K, Kensuke N et al (2015) Speccific organ metastase and survival in metastatic non-small cell lung cancer. Molecular and clinical oncology 3: 217-221.
16. Carlos G, Saya J, Brian SF et al (2020) The role of EGFR mutations in predicting recurrence in early and locally advanced lung adenocarcinoma following definitive therapy. Oncotarget 11(21): 1953-1960.
17. Yuankai S, Joseph Siu-Kie A, Sumitra T et al (2014) A prospective, molecular epidemiology study of EGFR mutations in Asian patients with Advanced non-small cell lung cancer of adenocarcinoma hiaatology (PIONEER). Journal of Thoracic Oncology 9(2): 154-162.
18. Yue-Lun Zhang, Jin-Qiu Yuan, Kai-Feng Wang et al (2016) The prevalence of EGFR mutation in patients with non-small cell lung cancer: A systematic review and meta-analysis. Oncotarget 7(48): 78985-78993.
19. Can Pi, Chong-Rui Xu, Ming-feng Zhang et al (2018) EGFR mutations in early-stage and advanced-stage lung ademocarcinoma: Analysis based on large-scale data from China. Thoracic Cancer 9: 814-819.
20. Lina Li, Shuimei Luo, Heng Lin et al (2017), Corelation between EGFR mutation status and the incidence of brain metastaes in patients with non-small cell lung cancer. J Thorac Dis 9(8): 2510-2520.
21. Yuya Fujita, Manabu Kinoshita, Tomohiko Ozaki et al (2020) The impact of EGFR mutation status and single brain metastasis on the survival of non-small cell lung cancer patients with brain metastases. Neuro – Oncology Advances 2(1): 1-8.
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LuậnP. V., TiếnN. Đình, & HảiN. M. (2021). Mối liên quan giữa đột biến gen EGFR với nguy cơ di căn não ở bệnh nhân ung thư phổi không tế bào nhỏ: Kết quả từ nghiên cứu tiến cứu. Journal of 108 - Clinical Medicine and Phamarcy, 16(1). https://doi.org/10.52389/ydls.v16i1.663