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Comparison of survival outcomes between de novo and recurrent stage IV gastric cancers: A retrospective cohort study 一项回顾性队列研究:新生期和复发期胃癌的生存结局比较
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-06-30 DOI: 10.23838/pfm.2023.00051
J. Ji, Kwang Min Kim, B. Kwan, Sung Kim, Y. S. Kim, Seong Hee Choi, M. H. Jin, B. Ha, Jinah Kim, Jeff Liang, N. Kim, Daniela Lee, J. D. Yang
Purpose: This study analyzes the characteristics and prognosis of patients with de novo and recurrent metastatic gastric cancers.Methods: This retrospective study included 301 advanced, pathologically confirmed gastric cancer patients who received palliative chemotherapy between 2012 and 2022. The de novo cohort included patients who presented with distant metastasis at diagnosis, and the recurrent metastatic cohort was composed of patients with metastasis after curative gastrectomy. We analyzed prognostic association by Cox regression and compared survival time of both cohorts using the Kaplan-Meier survival analysis.Results: The study included 167 de novo and 112 recurrent patients. No differences were noted among the patients with de novo disease and recurrent metastatic disease concerning age, sex, Eastern Cooperative Oncology Group scores, primary cancer location, and pathologic features. Patients in the recurrent group versus the de novo group had a longer duration of chemotherapy (1.16±1.18 years vs. 0.85±0.84 years, P= 0.01) and lower mean body mass index (20.22±2.78 kg/m2 vs. 21.93±3.38 kg/m2, P< 0.001). The median overall survival in the de novo group was 11.6 versus 14.4 months in the recurrent group (P= 0.02).Conclusion: De novo and recurrent metastatic gastric cancer are characterized by distinct subpopulations. Advanced gastric cancer patients with recurrence have significantly better survival versus those in the de novo cohort. The differences between de novo and recurrent gastric cancer patient outcomes could facilitate discussions about the selection of the clinical trial of each patient and help with their personalized treatment.
目的:分析新发及复发转移性胃癌患者的特点及预后。方法:回顾性研究301例2012 - 2022年间经病理证实接受姑息性化疗的晚期胃癌患者。新发队列包括诊断时出现远处转移的患者,复发转移队列由治愈性胃切除术后发生转移的患者组成。我们使用Cox回归分析预后相关性,并使用Kaplan-Meier生存分析比较两组患者的生存时间。结果:纳入167例新发患者和112例复发患者。新发疾病和复发转移性疾病患者在年龄、性别、东部肿瘤合作组评分、原发肿瘤位置和病理特征方面没有差异。复发组与新生组相比,化疗时间更长(1.16±1.18年比0.85±0.84年,P= 0.01),平均体重指数更低(20.22±2.78 kg/m2比21.93±3.38 kg/m2, P< 0.001)。新发组的中位总生存期为11.6个月,而复发组为14.4个月(P= 0.02)。结论:新生和复发转移性胃癌具有不同的亚群特征。晚期胃癌复发患者的生存率明显高于新生组患者。新发和复发胃癌患者预后的差异可以促进对每位患者临床试验选择的讨论,并有助于他们的个性化治疗。
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引用次数: 0
Case report of trans-renal ablation procedures for a recurrent pheochromocytoma in von Hippel-Lindau disease 经肾消融术治疗希佩尔-林道病复发性嗜铬细胞瘤病例报告
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-06-30 DOI: 10.23838/pfm.2023.00058
B. K. Park
Pheochromocytoma is one of recurrent tumors in patients with von Hippel-Lindau (VHL) disease. For patients with bilateral adrenal glands, unilateral adrenalectomy is the treatment of choice; however, for patients with a single adrenal gland, hemiadrenalectomy or tumorectomy can be performed instead of adrenalectomy to preserve adrenal function. Currently, adrenalectomy is recommended even if recurrent pheochromocytomas occur in the residual adrenal tissue. Consequently, adrenal insufficiency cannot be avoided in these patients. Percutaneous radiofrequency ablation (RFA) is used as an alternative treatment for preserving adrenal function; however, RFA is difficult to perform when major organs are present in the approaching pathway. The trans-hepatic approach is the only reported safe route to approach a right adrenal tumor to avoid pneumothorax. In this case report, we performed percutaneous RFA and hydrodissection through the left renal parenchyma to treat a recurrent pheochromocytoma in the small residual left adrenal tissue, which is surrounded by several critical organs. Our goal was to show our experience of image-guided trans-renal RFA and hydrodissection in a patient with VHL disease.
嗜铬细胞瘤是von Hippel-Lindau(VHL)病患者的复发性肿瘤之一。对于双侧肾上腺的患者,单侧肾上腺切除术是首选的治疗方法;然而,对于单一肾上腺的患者,可以进行半肾上腺切除术或肿瘤切除术,而不是肾上腺切除术,以保持肾上腺功能。目前,即使残留的肾上腺组织中出现复发性嗜铬细胞瘤,也建议进行肾上腺切除术。因此,这些患者的肾上腺功能不全是无法避免的。经皮射频消融术(RFA)是一种保留肾上腺功能的替代治疗方法;然而,当主要器官存在于接近的通路中时,RFA很难进行。经肝入路是唯一报道的安全途径,以接近右肾上腺肿瘤,以避免肺气肿。在本病例报告中,我们通过左肾实质进行了经皮RFA和水切除术,以治疗由几个关键器官包围的残留左肾上腺小组织中的复发性嗜铬细胞瘤。我们的目标是展示我们在VHL疾病患者中进行图像引导下经肾RFA和水切除的经验。
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引用次数: 0
Clinical features and test indications of 11,087 patients undergoing cardiac magnetic resonance imaging during a decade in a tertiary referral center: A retrospective observational study 十年来在三级转诊中心接受心脏磁共振成像的11087例患者的临床特征和检查指征:一项回顾性观察研究
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-06-30 DOI: 10.23838/pfm.2023.00023
S. Jang, Junghyun Kim, Yiseul Kim, Young Ae Chang, W. Jung, Hwang Og Kim, K. Yoo, Eun Kyoung Kim, Sung‐A Chang, Sung-Ji Park, S. Park, Duk-Kyung Kim, S. Kim, J. Huh, Jinyoung Song, I. Kang, S. Cho, J. Oh, Sang-Chol Lee, Yeonhyeon Choe
Purpose: We evaluated the clinical characteristics of patients undergoing cardiac magnetic resonance (CMR) examinations over 10 years at a tertiary referral hospital.Methods: This retrospective study included 11,087 CMR examinations performed between November 2009 and September 2020. The number of adults aged ≥20 years was 10,648 (72.8% males). A total of 439 children or young adults aged < 20 years underwent CMR (66.5% males). Indications for CMR examinations were classified according to the Consensus Panel recommendations of the Society for Cardiovascular Magnetic Resonance (SCMR).Results: The mean age was 55.9±12.4 years for adults. Forty percent of patients were obese. Leading cardiovascular risk factors were hypertension, dyslipidemia, diabetes mellitus, and current smoking status in 28.2%, 19.1%, 13.8%, and 25.4% of patients, respectively. The proportion of stress CMR examinations performed was 57.2%. For children, the mean age was 12.6±5.3 years. Most children underwent a non-stress CMR test. In adults without congenital heart disease, indication numbers for SCMR classes were 5,682 for class I (49.4%), 772 for class II (6.7%), 313 for class III (0.3%), and 4,714 for investigational group (41.1%). In pediatric patients and adults with congenital heart disease, indication numbers for SCMR classes were 539 for class I (80.3%), 62 for class II (9.2%), and 70 for the investigational group (10.4%).Conclusion: CMR is most commonly performed in men in their 50s or 60s. CMR may be used as the first-line imaging technique (SCMR class I) in around a half of adult patients and in most pediatric patients.
目的:我们评估了在三级转诊医院接受心脏磁共振(CMR)检查10年的患者的临床特征。方法:本回顾性研究包括2009年11月至2020年9月期间进行的11087次CMR检查。年龄≥20岁的成年人为10648人(72.8%为男性)。总共有439名年龄<20岁的儿童或年轻人接受了CMR(66.5%为男性)。根据心血管磁共振学会(SCMR)的共识小组建议对CMR检查的适应症进行分类。结果:成人的平均年龄为55.9±12.4岁。40%的患者肥胖。主要心血管危险因素分别为28.2%、19.1%、13.8%和25.4%的患者的高血压、血脂异常、糖尿病和当前吸烟状况。进行压力CMR检查的比例为57.2%。儿童的平均年龄为12.6±5.3岁。大多数儿童接受了无压力CMR测试。在没有先天性心脏病的成人中,SCMR类别的适应症数量为:I类5682个(49.4%),II类772个(6.7%),III类313个(0.3%),试验组4714个(41.1%),研究组70例(10.4%)。结论:CMR最常见于50多岁或60多岁的男性。CMR可作为一线成像技术(SCMR I类)用于约一半的成年患者和大多数儿科患者。
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引用次数: 0
Utility of renal artery ultrasound for detecting stenosis or obstruction A narrative review 肾动脉超声检查狭窄或梗阻的应用综述
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-04-07 DOI: 10.23838/pfm.2023.00009
B. K. Park
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引用次数: 0
Angiogenesis effect of udenafil in a caveolin-1 deficient moyamoya disease model: A pre-clinical animal study 乌地那非对caveolin-1缺陷型烟雾病模型血管生成作用的临床前动物研究
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-31 DOI: 10.23838/pfm.2022.00135
Dong Hee Kim, Jeong Pyo Son, Y. Cho, Eun Hee Kim, Gyeong Joon Moon, Oh Young Bang
Purpose: Although pathogenic mechanisms of moyamoya disease (MMD) remain unknown, recent studies suggest that it is a caveolae disease. This study evaluated the effect of udenafil, a phosphodiesterase-5 inhibitor, on angiogenesis in in vitro and in vivo MMD models.Methods: Angiogenesis and vessel maturation were assessed in in vitro models, caveolin- 1 (Cav-1) knockdown human umbilical vessel endothelial cells (HUVECs) and coronary artery smooth muscle cells (CASMCs), and in in vivo model of bilateral internal carotid artery occlusion (bICAo). Udenafil was administered (1,3,10, and 30 μM) in cell culture conditions, and functional studies (migration and tube formation assay) were performed and vessel maturation factors and cyclic guanosine monophosphate (cGMP) accumulation were measured.Results: Udenafil (3 and 10 mg/kg) was orally administered once daily for 4 weeks in bICAo rat model, and histological analysis for angiogenesis and vessel maturation was performed. Udenafil increased vessel formation in both Cav-1 knockdown HUVEC and bICAo models without increased migration/proliferation of HUVECs and CASMCs. Udenafil increased CD31+ vessel density and NG2/Col4+ mural cell density in bICAo models. Cav-1 knockdown inhibited accumulation of cGMP, and udenafil treatment restored cGMP levels in Cav-1 knockdown HUVEC models. Vessel maturation factors (angiopoietin- 1 and platelet-derived growth factor receptor-β) and angiogenic factors (endothelial nitric oxide synthase) were increased after treatment with udenafil in vitro.Conclusion: Our results indicate that udenafil reversed cellular levels of cGMP related to Cav-1 deficiency and induced angiogenesis and vessel maturation. Further studies are warranted to confirm the therapeutic effects of this strategy in MMD.
目的:虽然烟雾病(MMD)的致病机制尚不清楚,但最近的研究表明它是一种小窝病。本研究评估了磷酸二酯酶-5抑制剂乌地那非在体外和体内MMD模型中对血管生成的影响。方法:在体外模型、Cav-1敲除人脐血管内皮细胞(HUVECs)和冠状动脉平滑肌细胞(CASMCs)以及双侧颈内动脉闭塞(bICAo)的体内模型中评估血管生成和血管成熟。在细胞培养条件下给予乌地那非(1,3,10和30μM),并进行功能研究(迁移和试管形成测定),测量血管成熟因子和环磷酸鸟苷(cGMP)积累。结果:在bICAo大鼠模型中,每天口服一次乌地那非(3和10mg/kg),持续4周,并对血管生成和血管成熟进行组织学分析。在Cav-1敲低的HUVEC和bICAo模型中,乌地那非都增加了血管形成,而没有增加HUVECs和CASMC的迁移/增殖。乌地那非在bICAo模型中增加了CD31+血管密度和NG2/Col4+壁细胞密度。在Cav-1敲低的HUVEC模型中,Cav-1的敲低抑制了cGMP的积累,而乌地那非治疗恢复了cGMP水平。血管成熟因子(血管生成素-1和血小板衍生生长因子受体-β)和血管生成因子(内皮一氧化氮合酶)在体外用乌地那非治疗后增加。结论:我们的研究结果表明,乌地那非逆转了与Cav-1缺乏相关的细胞cGMP水平,并诱导了血管生成和血管成熟。需要进一步的研究来证实这种策略在MMD中的治疗效果。
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引用次数: 0
Signatory metabolomics biomarkers of stress, anxiety, and depression: a proof of concept for precision health among university students: A cross-sectional study 压力、焦虑和抑郁的标志性代谢组学生物标志物:大学生精确健康概念的证明:一项横断面研究
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-31 DOI: 10.23838/pfm.2022.00128
Nur Izzati Umar Zaman, T. L. Kek, Rohana Ahmad, Mohd Nur Fakhruzzaman Noorizhab, M. Rofiee, R. James, N. M. Nor, Mawarni Mohamed, Teoh Sian Hoon, P. Singh, R. Janor, S. H. A. Bakar, M. Z. Salleh
Purpose: The highly competitive nature of tertiary education and the pressure to perform academically have increased psychological morbidity like emotional distress. Untargeted metabolomics was used to analyze serum samples of university students for biomarkers and perturbated metabolism due to stress, anxiety, and depression (SAD).Methods: Depression, Anxiety, Stress Scale 21 (DASS-21) was used to assess the severity of SAD in university students. The metabolite fingerprint of each subject was obtained using liquid chromatography-mass spectrometry quadrupole time-of-flight (LC/MS QTOF). The signature metabolites for each trait were determined by projections to latent structures discriminant analysis (PLS-DA) with variable importance for the projection (VIP) score > 1.0 (P<0.05) and subjected to analysis using the area under the receiver operating characteristic curve (AUROC). Potential biomarkers with an area under the curve (AUC) value exceeding 0.65 were identified.Results: Various groups of glycerophospholipids were upregulated in the studied traits. On the other hand, metabolites such as glycocholic acid was upregulated in depression, while hypoxanthine was upregulated in anxiety, and PE-Cer(d14:1(4E)/22:1(13Z)) was upregulated in stress.Conclusion: To our knowledge, this is the first study to assess the relationship of the differentially expressed metabolites in university students of different categories of SAD using the DASS-21 screening tool in Malaysia as we move forward with precision health.
目的:高等教育的高度竞争性质和学业上的压力增加了心理疾病,如情绪困扰。非靶向代谢组学用于分析大学生血清样本的生物标志物和由压力、焦虑和抑郁(SAD)引起的代谢紊乱。方法:采用抑郁、焦虑、压力量表21 (DASS-21)对大学生SAD的严重程度进行评估。采用液相色谱-质谱联用四极杆飞行时间(LC/MS QTOF)获得各受试者代谢物指纹图谱。每个性状的特征代谢物采用投影潜结构判别分析(PLS-DA)确定,对投影(VIP)评分> 1.0 (P<0.05)具有可变重要性,并使用受试者工作特征曲线下面积(AUROC)进行分析。鉴定出曲线下面积(AUC)大于0.65的潜在生物标志物。结果:不同组的甘油磷脂在研究性状中表达上调。另一方面,代谢物如糖胆酸在抑郁时上调,次黄嘌呤在焦虑时上调,PE-Cer(d14:1(4E)/22:1(13Z))在应激时上调。结论:据我们所知,这是第一个在马来西亚使用DASS-21筛选工具评估不同类别SAD大学生差异表达代谢物之间关系的研究,因为我们正在推进精准健康。
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引用次数: 0
Stages of renal artery stenosis: a hypothesis based on ultrasound findings: A narrative review 肾动脉狭窄的分期:基于超声结果的假说:叙述性综述
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-31 DOI: 10.23838/pfm.2022.00149
B. K. Park
Current ultrasound (US) scanners can directly detect renal artery stenosis (RAS) in which the degree is the same irrespective of heart beat. Frequently, however, blood pressure or renal function is not improved because the stage of RAS is too late. Therefore, RAS should be early detected and thus the radiologists are familiar with US features of early, intermediate, and late RAS. Atherosclerosis is the most common etiology to RAS and begins inflammation from the intima of renal artery. Accordingly, we can hypothesize that there are multi-stages going to the final RAS. At early stage, RAS can be detected on diastolic phase alone. However, at intermediate stage, it begins to be seen on systolic phase and is more severe on diagnostic phase than that at early stage. Finally, at late stage, RAS is seen at the same degree regardless of heart beats because the stenosis is fixed due to fibrosis. The purpose of this review is to introduce a hypothesis on the stages of RAS, to show the renal artery US features of each stage, and to compare US and angiography in terms of RAS detection.
目前的超声(US)扫描仪可以直接检测到肾动脉狭窄(RAS),其程度与心脏跳动无关。然而,由于RAS分期太晚,血压或肾功能往往得不到改善。因此,RAS应及早发现,因此放射科医生熟悉美国早期、中期和晚期RAS的特征。动脉粥样硬化是RAS最常见的病因,始于肾动脉内膜的炎症。因此,我们可以假设到最后的RAS有多个阶段。早期RAS仅在舒张期即可检测到。然而,在中期,它开始出现在收缩期,并在诊断期比早期更严重。最后,在晚期,由于狭窄因纤维化而固定,无论心跳次数如何,RAS均呈相同程度。本综述的目的是对RAS的分期进行假设,展示各阶段肾动脉超声特征,并比较超声与血管造影在RAS检测方面的差异。
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引用次数: 0
Tau positron emission tomography in tauopathies: A narrative review Tau正电子发射断层扫描在Tau病中的应用:叙述性综述
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-31 DOI: 10.23838/pfm.2023.00016
Hyunjong Lee, Yuna Gu, S. Seo, S. Moon
Aggregation of misfolded tau in the brain is a major pathological feature common in various neurodegenerative disorders known as tauopathies, including Alzheimer’s disease, progressive supranuclear palsy, corticobasal syndrome, and dementia with Lewy bodies. Tauopathies are collection of diseases with varied overlapping symptoms and complicated manifestations. Consequently, it is crucial to be able to assess tau deposits in vivo. Over the past decade, tau-specific radioligands for positron emission tomography (PET) have been developed and tested, including first-generation compounds (e.g., 18F-THK5317, 18F-THK5351, 18F-AV1451, and 11C-PBB3) and second-generation compounds (18F-MK-6240, 18F-RO-948, and 18F-PI-2620). With the recent advances of tau PET tracers, assessing the pattern of tau deposition in vivo is possible. These methods will allow accurate diagnosis of tauopathies and monitoring of disease progression. In this mini review, we summarize current findings from studies using tau PET tracers regarding neuropathological characteristics, clinical implications, and potential applications of tau PET. We also discuss methodological considerations for appropriate use of these technologies and discuss what has been learned from these findings.
大脑中错误折叠的tau聚集是各种被称为tau病的神经退行性疾病中常见的一个主要病理特征,包括阿尔茨海默病、进行性核上性麻痹、皮质基底综合征和路易体痴呆。Taopathies是一系列具有各种重叠症状和复杂表现的疾病。因此,能够在体内评估tau沉积是至关重要的。在过去的十年中,已经开发和测试了用于正电子发射断层扫描(PET)的τ特异性放射性配体,包括第一代化合物(例如,18F-THK5317、18F-THK5351、18F-AV1451和11C-PBB3)和第二代化合物(18F-MK-6240、18F-RO-948和18F-PI-2620)。随着τPET示踪剂的最新进展,评估体内τ沉积的模式是可能的。这些方法可以准确诊断tau病并监测疾病进展。在这篇小型综述中,我们总结了使用tau PET示踪剂进行的关于tau PET的神经病理学特征、临床意义和潜在应用的研究的最新发现。我们还讨论了适当使用这些技术的方法考虑因素,并讨论了从这些发现中学到了什么。
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引用次数: 0
Message from the Precision and Future Medicine editors to our ad hoc reviewers Precision和Future Medicine编辑给我们的特别评审员的信息
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-31 DOI: 10.23838/pfm.2023.00030
H. Jeon
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引用次数: 0
Evaluation of MET alteration in EGFR-mutant non-small cell lung cancer patients treated with EGFR tyrosine kinase inhibitor from paired biopsy: A retrospective cohort study 配对活检中EGFR酪氨酸激酶抑制剂治疗的EGFR突变型癌症患者MET改变的评估:一项回顾性队列研究
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-12-31 DOI: 10.23838/pfm.2022.00058
B. Ku, Sungwon Park, Sehhoon Park, H. Jung, Jong-Mu Sun, Se-Hoon Lee, J. Ahn, Yoon-La Choi, M. Ahn
Purpose: Mesenchymal-epithelial transition tyrosine kinase receptor (MET) amplification is one of the common acquired resistance mechanisms to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). To evaluate the usefulness of screening methods for MET status, we studied the impact of MET amplification or protein overexpression in EGFR-mutant non-small cell lung cancer patients who were treated with EGFR TKI.Methods: A total of 214 patients treated with EGFR TKI as first-line therapy with available tissue biopsy was analyzed. Paired biopsies were obtained from 111 patients at baseline and at onset of resistance. MET status was determined by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH).Results: Among 111 patients with paired samples, incidence of MET alteration was increased according to both MET overexpression by IHC (14.4% to 22.5%) and MET amplification by FISH (1.8% to 8.1%) with moderated to strong IHC intensity samples after EGFR TKI treatment. In patients treated with 1st-generation EGFR TKI, MET amplification by FISH was significantly related to shorter progression-free survival (P=0.04) and overall survival (P=0.01). In contrast, there was no difference in clinical outcomes according to MET intensity of IHC. Patients harboring MET amplification by FISH were associated with poor clinical outcomes compared to those with T790M mutation at progression.Conclusion: These results suggest that FISH is more informative than IHC for identification of patients with MET amplification as an EGFR TKI resistance mechanism. Given the poor outcome in patients who developed MET amplification, combinational trials with more active MET inhibitor are needed to overcome resistance.
目的:间充质上皮转化酪氨酸激酶受体(MET)扩增是对表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKI)常见的获得性耐药机制之一。为了评估MET状态筛查方法的有效性,我们研究了在接受EGFR TKI治疗的EGFR突变型癌症患者中MET扩增或蛋白过度表达的影响。方法:对214例接受EGFR-TKI一线治疗的患者进行分析。111名患者在基线和耐药性发作时进行了配对活检。MET状态通过免疫组织化学(IHC)和荧光原位杂交(FISH)测定。结果:在111名配对样本的患者中,EGFR-TKI治疗后,根据IHC对MET的过度表达(14.4%-22.5%)和FISH对MET扩增(1.8%至8.1%),中等强度至强强度样本的MET改变发生率增加。在接受第一代EGFR-TKI治疗的患者中,FISH扩增MET与较短的无进展生存期(P=0.04)和总生存期(P<0.01)显著相关。相反,根据IHC的MET强度,临床结果没有差异。与进展中携带T790M突变的患者相比,通过FISH携带MET扩增的患者的临床结果较差。结论:这些结果表明,FISH比IHC更有助于识别MET扩增作为EGFR-TKI耐药机制的患者。鉴于MET扩增患者的不良结果,需要使用更活性的MET抑制剂进行联合试验来克服耐药性。
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引用次数: 0
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