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目的:探讨非小细胞肺癌HER2基因突变的临床特征和预后。方法:回顾性分析15例HER2基因突变的非小细胞肺癌临床特征,Kaplan-Meier法计算生存率,log-rank法进行生存率显著性检验。结果:非小细胞肺癌中HER2基因突变率1.92%(15/781),女性患者突变率高于男性患者(3.76% vs 1.23%,P=0.022),吸烟患者突变率高于未吸烟患者(3.17% vs 0.74%,P=0.027),中位生存时间42.6个月,其中复合突变12例,中位生存时间42.6个月,单纯突变3例,中位生存时间40.3个月,两者差异无统计学意义(P=0.43);伴随EGFR基因突变8例,中位生存时间50.6个月,不伴随EGFR基因突变7例,中位生存时间42.6个月(P=0.19),伴随TP53基因突变9例,中位生存时间40.4个月,不伴随TP53基因突变6例,中位生存时间46.7个月(P=0.39),伴随SMARCA4基因突变2例,中位生存时间50.6个月,不伴随SMARCA4基因突变13例,中位生存时间42.6个月(P=0.33),伴随MTOR基因突变2例,中位生存时间44.3个月,不伴随MTOR基因突变13例,中位生存时间42.6个月(P=0.71),伴随APC基因突变2例,中位生存时间39.0个月,不伴随APC基因突变13例,中位生存时间42.6个月(P=0.92)。结论:非小细胞肺癌HER2基因突变在女性未吸烟患者中多见,伴随基因状态对HER2基因突变预后可能影响不大。
Objective: To investigate the clinical characteristics and prognosis of HER2 gene mutation in non-small cell lung cancer. Methods: The clinical features of 15 patients with HER2 mutation were analyzed retrospectively. The survival rate was calculated by Kaplan-Meier method and the log-rank test was used to evaluate the survival rate. Results: The mutation rate of HER2 gene in non-small cell lung cancer was 1.92% (15/781). The mutation rate of female patients was higher than that of male patients (3.76% vs 1.23%, P = 0.022). The mutation rate of smoking patients was higher than that of non-smoking patients % vs 0.74%, P = 0.027). The median survival time was 42.6 months, of which 12 were composite mutations with a median survival time of 42.6 months. Only 3 patients had a simple mutation and the median survival time was 40.3 months (P = 0.43). With the EGFR mutation in 8 cases, the median survival time was 50.6 months without 7 cases of EGFR gene mutation and the median survival time was 42.6 months (P = 0.19). There were 9 cases with TP53 gene mutation , The median survival time was 40.4 months, 6 cases without TP53 gene mutation, the median survival time was 46.7 months (P = 0.39), 2 cases with SMARCA4 gene mutation and the median survival time was 50.6 months without SMARCA4 gene mutation The median survival time was 42.6 months (P = 0.33). Two patients with MTOR gene mutation had a median survival time of 44.3 months. There was no MTOR gene mutation in 13 patients and the median survival time was 42.6 months (P = 0.71) ). Two patients with APC gene mutation had a median survival time of 39.0 months without APC mutation in 13 patients and a median survival time of 42.6 months (P = 0.92). Conclusion: The mutation of HER2 gene in non-small cell lung cancer is more common in female non-smokers. The gene status may have little effect on the prognosis of HER2 gene mutation.