PD-1抑制剂对EGFR与KRAS基因突变晚期非小细胞肺癌患者的疗效及预后影响因素分析

摘要/Abstract

摘要： 目的分析程序性死亡受体1（PD-1）抑制剂对EGFR与KRAS基因突变晚期非小细胞肺癌（NSCLC）患者的疗效及预后影响因素。方法选取2021年1月—2023年12月在内蒙古自治区人民医院接受治疗的100例晚期NSCLC患者,均接受了PD-1抑制剂的治疗。根据驱动基因的不同变异类型分为两组：EGFR组45例,KRAS组55例。对比两组患者接受免疫疗法后的治疗效果及生存预后,并探讨影响预后的相关因素。结果所有患者的疾病总控制率为92.00%（92/100）。KRAS组的疾病总控制率（98.18%）高于EGFR（84.44%）,差异有统计学意义（P<0.05）。KRAS组无进展生存期（PFS）、总生存期（OS）长于EGFR组,差异有统计学意义（P<0.05）。经Cox回归分析,年龄≥60岁（HR=2.333）、吸烟史（HR=2.633）、驱动突变基因类型（HR=3.089）、PD-L1表达水平阴性（HR=3.912）为PFS的独立影响因素（P<0.05）。结论晚期NSCLC患者接受免疫治疗可取得较好的效果,针对KRAS基因突变晚期NSCLC患者,免疫检查点抑制剂单药治疗总体效果较好,EGFR基因突变患者的预后相对较差。年龄、吸烟史、不同驱动突变基因、PD-L1表达水平为预后影响因素。

关键词: 晚期非小细胞肺癌, 驱动基因, 突变, 免疫检查点抑制剂, 免疫治疗, 预后

中图分类号:

R734.2

武艳梅. PD-1抑制剂对EGFR与KRAS基因突变晚期非小细胞肺癌患者的疗效及预后影响因素分析[J]. 中华养生保健, 2025, 43(12): 193-196.

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