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目的阐述非小细胞肺癌(NSCLC)中表皮生长因子受体(EGFR)突变与表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)临床敏感性及耐药性之间的关系。方法分析总结已经发表的国内外相关文献,对非小细胞肺癌治疗中EGFR-TKI的敏感性和耐药性进行介绍。结果在NSCLC患者中用EGFR-TKI治疗有效性和EGFR活化性突变有着紧密的联系,二者都在亚洲人种,女性,不吸烟,腺癌患者中发生率较高;患者对EGFR-TKI耐药不仅与EGFR二次突变有关,还与KRAS突变,HER2过表达,蛋白酪氨酸磷酸酶基因(PTEN)缺失,胰岛素样生长因子受体1(IGFR-1)过表达等有联系。结论EGFR突变可作为临床衡量EGFR-TKI敏感性指标;耐药机制复杂多变,目前还没有完全研究清楚。
Objective To elucidate the relationship between epidermal growth factor receptor (EGFR) mutation and clinical sensitivity and drug resistance of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) in non-small cell lung cancer (NSCLC). METHODS: We analyzed the published domestic and foreign literatures and introduced the sensitivity and drug resistance of EGFR-TKI in the treatment of non-small cell lung cancer. RESULTS: The efficacy of EGFR-TKI therapy in NSCLC patients is closely related to EGFR-activating mutations, both of which have high prevalence in Asian races, women, non-smoking, and adenocarcinomas; patients resistant to EGFR-TKI The drug is not only related to the secondary mutation of EGFR, but also related to KRAS mutation, HER2 overexpression, loss of protein tyrosine phosphatase gene (PTEN) and overexpression of insulin-like growth factor receptor 1 (IGFR-1). Conclusions EGFR mutation can be used as a clinical indicator of EGFR-TKI sensitivity. The mechanism of drug resistance is complex and changeable. It has not yet been fully studied.