联合检测四种分子标志物指导下的NSCLC患者个体化治疗策略的研究-内科学(呼吸系病)专业论文.docxVIP

第三军医大 第三军医大学硕士学位论文 万方数据 万方数据 Tu mo rs RNase R ibo nuc lease 核 糖 核 酸 酶 RNA R ibo nuc leot ide 核 糖 核 酸 RRM1 R ibo nuc leot ide reduct ase subunit M1 核糖核苷酸还原酶 M1 SD Stable disease 稳 定 Sp in Co lu mn Sp in Co lu mn 离 心 柱 T KIs Tyros ine k inase inhibito rs 酪 氨 酸 激 酶 抑 制 剂 VE GF Vascular endot he lia l growt h factor 血 管 内 皮 生 长 因 子 2 Individualized Therapy for NSCLC Patients Based on Combined Detection of Four Biomarkers Abstract Research background: Lung cancer is still the leading cause of morbidity and mortalityin the worldwide. NSCLC accountsfor 80 to 85 percent. More than 70 percent of patients with lung cancer are diagnosed with advanced(stage IIIB-IV) NSCLC,following a poor prognosis. These patients can only receive medical treatment,such as chemotherapy, targeted therapy and others. Although certain subgroup of patient s obtained a better outcome with the advancement of medical science, the total therapeutic efficacy is still not optimist ic. Tradit ional treatment strategies, for example chemotherapy, are mainly based on the same clinical characteristics, such as pathology and stage. Therefore, there is no deep sense to think about individual therapy and is unlikely to bring a fundamental change for NSCLC. The ORR is only about 30 percent and median PFS is 8 to 10 months, with a survival rate at one year of about 30 percent[1 ]. In recent years, with the development of cancer genomics and proteomics, the difference of certain genes mutation or expression is found to be closely related to the disease occurrence, development, treatment, and prognosis for NSCLC.Studies have shown that EGFR, KRAS, ERCC1, and RRM1 genes mutatio n or expression are important and potential basis for guidance of personal therapy for NSCLC patients. Through the four specific molecular bio markers screening mentioned above,the NSCLC patients,efficacy to targeted therapy and chemotherapy is significantly higher than the unscreening group[2 -5 ]. In order to assess whethe