Frequency of brain metastases in non-small-cell lung cancer, and their association with epidermal growth factor receptor mutations
Frequency of brain metastases in non-small-cell lung cancer, and their association with epidermal growth factor receptor mutations
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DOI：
10.1007/s10147-014-0760-9
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发表时间：
2015-08-01
影响因子：
3.3
通讯作者：
Iizasa, Toshihiko
中科院分区：
文献类型：
--
作者：
Iuchi, Toshihiko;Shingyoji, Masato;Iizasa, Toshihiko
脑是非小细胞肺癌（NSCLC）转移的常见部位。我们分析了非小细胞肺癌脑转移（BM）的频率在磁共振成像的时代，并评估了表皮生长因子受体（EGFR）突变和BM之间的相关性among East Asian patients.Methods的频率，数量和BM的大小，和生存的1,127例非小细胞肺癌患者进行了回顾性分析。结果EGFR突变331例（29.4%），突变率为100%。BM是52例患者（4.6%）的主要症状的原因，在其他102例患者（9.1%）开始治疗前发现;除这154例患者外，107例患者（9.5%）发生BM，因此在1，127例NSCLC患者中共有261例患者（23.2%）发生BM。EGFR突变病例的BM频率（31.4%）高于EGFR野生型病例（19.7%;比值比：1.86; 95%置信区间（CI）1.39-2.49; P < 0.001）。EGFR突变的NSCLC的BM较小，但通常会扩散。EGFR突变占BM的39.9%，但BM后EGFR突变患者的生存期明显长于EGFR野生型患者（危险比：2.23，95%CI 1.62-3.10; P < 0.001）。
Background The brain is a frequent site of metastases from non-small-cell lung cancer (NSCLC). We analyzed the frequency of brain metastases (BMs) from NSCLC in the era of magnetic resonance images, and evaluated the correlation between epidermal growth factor receptor (EGFR) mutations and BMs among East Asian patients.Methods Frequency, number, and size of BMs, and survival of 1,127 NSCLC patients were retrospectively reviewed. Mutation status of EGFR was evaluated in all cases, and its association with BMs was statistically evaluated.Results EGFR mutations were found for 331 cases (29.4 %). BM was the cause of primary symptoms for 52 patients (4.6 %), and found before initiation of treatment for 102 other patients (9.1 %); In addition to these 154 patients, 107 patients (9.5 %) developed BMs, giving a total of 261 patients (23.2 %) who developed BMs from 1,127 with NSCLC. BM frequency was higher among EGFR-mutated cases (31.4 %) than EGFR-wild cases (19.7 %; odds ratio: 1.86; 95 % confidence interval (CI) 1.39-2.49; P < 0.001). BMs from EGFR-mutated NSCLC were small, but often became disseminated. EGFR mutations accounted for 39.9 % of BMs, but patient survival after BMs was significantly longer for EGFR-mutated cases than for EGFR-wild cases (hazard ratio: 2.23; 95 % CI 1.62-3.10; P < 0.001).Conclusion Patients with EGFR-mutated NSCLC were more likely to develop BMs, but apparently also survived longer after BMs.