| Objective: Lung cancer is currently one of the most common malignant tumors in the world, the mortality rate has become the world's top tumor, and the world will have 1.3 million new cases of lung cancer each year. China's morbidity and mortality of lung cancer are also being in the first place, as well as the rapid growth of female morbidity and mortality has been considered to be the biggest barrier to the national health. With non-small cell lung cancer(NSCLC) accounts for about 75%- 80% of all lung cancers. Through the expert consensus of molecular targeted therapy of advanced non-small cell lung cancer: for patients with sensitive mutation of EGFR gene of advanced NSCLC, recommending the first line to use EGFR-TKI; EGFR-TKI can also be used for the treatment of second line or third line in patients with advanced NSCLC. Technology of diagnosing is still limited to patients of lung cancer by using of tissue samples. However, the processions of drawing materials are difficult, as well as there are also some risks. So many patients of advanced lung cancer do not want to accept the biopsy. Instead, the simple and convenient application samples, which have less pains and better specificity as well as high sensitivity, may replace the surgical tissue samples.It is well-known that the testing of ctDNA EGFR in plasma has played an important role during the process of diagnosis. Therefore, under the background of the study, the detection of ctDNA EGFR mutation status becomes the development trend.The free tumor DNA of advanced NSCLC patients in peripheral blood is mainly composed of apoptosis and necrosis of tumor cells, as well as the genetic characteristics are similar to the DNA of tumor itself. The numbers of free tumor DNA are ten times as much as the healthy persons. As is known, the peripheral blood is convenient and if EGFR mutations can be detected, it can greatly reduce the difficulty of the organization based. A large number of clinical studies have shown that: Firstly, the mutation of EGFR in blood is earlier than the tumor progression which is found in the imaging; Secondly,it has the function of real-time monitoring of the cancer, and can predict treatment effects; Thirdly, it can also monitor the mutations situation of drug resistance to pursue for drugs.The purpose of this study is to investigate the sensitivity group of EGFR + gene mutation advanced non-small cell lung cancer patients with the blood test results; to explore the valuation of EGFR mutations of the blood detection in patients with advanced non-small cell lung cancer; to help doctor how to be better used of the clinical individualized medication.Methods:The patients from Shandong cancer hospital with biopsy-proven Advanced Non-Small-Cell Lung cancer were enrolled into this prospective study. Extracting the peripheral venous blood of 8 ml and sodium citrate anticoagulation. Using real-time fluorescent quantitative PCR technology to detect the mutations of plasma DNA. The sensitivity analysis between tissue EGFR + gene mutations and the blood test results in the advance non-small cell lung cancer patients will be processing. Using SPSS17.0 software for the statistical analysis.Results:23 patients with advanced non-small cell lung cancer(stage III or IV) in the tissue EGFR + mutation are enrolled and its blood testing results of the sensitivity are 60.87%(14/23). Clinical data analysis: the only clinical stage(stage III or IV) is different(p < 0.001).Conclusion:At present, the detection of EGFR mutations of tissue biopsy of advanced non-small cell lung cancer is still regarded as the gold criterion; the detection of EGFR mutations in blood plays a complementary role in some circumstances. |
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