肺腺癌pd-l1表达与egfr突变的相关性研究

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1、授予单位代码10089学号或申请号20153528中国图书分类号R734.2HebeiMedicalUniversity硕士学位论文专业学位肺腺癌PD-L1表达与EGFR突变的相关性研究研究生：杨春旺导师：汪治宇教授专业：肿瘤学二级学院：第四医院2018年3月目录中文摘要·················································································1英文摘要························································

2、·························2英文缩写·················································································3综述肺腺癌PD-L1表达与EGFR突变的相关性研究····················4致谢·····················································································22个人简历···························

3、····················································23中文摘要肺腺癌PD-L1表达与EGFR突变的相关性研究摘要肺癌是癌症相关死亡的首要病因，非小细胞肺癌（non-smallcelllungcancer,NSCLC）的靶向治疗已成为肿瘤―精准治疗‖的典范。表皮生长因子受体（epidermalgrowthfactorreceptor,EGFR）作为肺癌治疗的主要靶点，其靶向药物的研究大大提高了肺癌治疗的有效率（responserate,RR）、客观反应率（objectiveresponserates

4、,ORRs）及无进展生存时间（progress-ionfreesurvival,PFS）。然而，继发性耐药的产生使靶向药物的发展出现了瓶颈。目前克服EGFR酪氨酸激酶抑制剂（EGFR-tyrosinekinaseinhibitor,EGFR-TKI）的耐药机制方法之一是寻找有效的预测靶标，使治疗更加个体化。随着肺癌免疫治疗时代的到来，有关PD-1/PD-L1通路的研究也逐步增多。PD-1/PD-L1在不同的恶性肿瘤中的表达特点各不相同，在肺癌中常常与各项临床病理参数、淋巴结转移及患者预后等存在相关性，然而PD-1/PD-L1抑制剂作为单药治疗或与其他

5、抗肿瘤治疗联合在非小细胞肺癌中存在争议，近期发现肺癌中程序性死亡配体-1（programmeddeadthligand-1PD-L1）的高表达与EGFR敏感突变相关，此外两种靶向药物的联合使用也成为目前研究的热点。本文就PD-L1与EGFR突变在肺腺癌中的相关性研究进行阐述。关键字：肺腺癌，表皮生长因子受体酪氨酸激酶抑制剂，程序性死亡配体-1，预后因子，精准治疗1英文摘要CorrelationbetweenPD-L1expressionandEGFRmutationinlungadenocarcinomaABSTRACTInrecentyears,l

6、ungcancerhasbeentheleadingcauseofcancer-relateddeadth.Thetargetedtherapyofnon-smallcelllungcancer(NSCLC)becomesthemodelofprecisiontherapy.Epidermalgrowthfactorreceptor-tyrosinekinaseinhibitor(EGFR-TKI),whichepidermalgrowthfactorreceptor(EGFR)isthemaintarget,greatlyimprovesrespo

7、nserate(RR),objectiveresponserate(ORR)andprogressionfreesurvival(PFS)inNSCLC.However,acquiringresistanceareinevitable,whichlimitesthedevelopmentoftargetmedicine.Now,theeffectivepredictiontargetmayovercomeresistance-drug.Thiscanmakethetherapyoftargetmedicinemoreindividualized.Wi

8、ththeadventoftheeraofimmunotherapyoflungcancer,therese