{"id":72090,"date":"2018-11-10T01:00:00","date_gmt":"2018-12-07T05:02:22","guid":{"rendered":"http:\/\/www.05921.net\/index.php\/2018\/12\/07\/51f26903e8\/"},"modified":"2018-12-07T13:02:24","modified_gmt":"2018-12-07T05:02:24","slug":"51f26903e8","status":"publish","type":"post","link":"https:\/\/www.05921.net\/index.php\/72090\/","title":{"rendered":"\u76f4\u51fbACLC | \u9646\u821c\uff1actDNA\u5728\u9a71\u52a8\u57fa\u56e0\u9633\u6027\u80ba\u764c\u4e2d\u7684\u5e94\u7528"},"content":{"rendered":"
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\"\u76f4\u51fbACLC<\/p>\n


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\"\u76f4\u51fbACLC<\/p>\n
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\u7275\u624b\u533b\u5c4a\u5927\u5496<\/span><\/strong><\/span><\/p>\n

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\u5b50\u53f7\u201c\u514d\u75ab\u65f6\u95f4<\/span>\u201d<\/strong><\/span><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\"\u76f4\u51fbACLC<\/section>\n<\/section>\n<\/section>\n


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\u6765\u6e90\uff1a\u514d\u75ab\u65f6\u95f4<\/span>
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\u3000\u3000\u201c\u7cbe\u51c6\u7684\u68c0\u6d4b\u662f\u7cbe\u51c6\u6cbb\u7597\u7684\u524d\u63d0\u3002\u201d<\/strong>2018\u4e9a\u6d32\u80ba\u764c\u5927\u4f1a\u5171\u540c\u4e3b\u5e2d\u3001\u4e2d\u56fd\u6297\u764c\u534f\u4f1a\u80ba\u764c\u4e13\u4e1a\u59d4\u5458\u4f1a\u4e3b\u4efb\u59d4\u5458\u3001\u4e0a\u6d77\u4ea4\u901a\u5927\u5b66\u9644\u5c5e\u80f8\u79d1\u533b\u9662\u80bf\u7624\u79d1\u4e3b\u4efb\u9646\u821c\u6559\u638811\u67088\u65e5\u5728\u4e9a\u6d32\u80ba\u764c\u5927\u4f1a\u4e0a\u5f3a\u8c03\uff0c\u672a\u6765\u7684\u80ba\u764c\u6cbb\u7597\u7b56\u7565\u5e94\u5f53\u66f4\u771f\u5b9e\u5730\u63a5\u8fd1\u80bf\u7624\u9057\u4f20\u5b66\u7279\u6027\uff0c\u57fa\u4e8e\u751f\u7269\u5206\u5b50\u7279\u5f81\u8c31\u6765\u6cbb\u7597\u3002<\/p>\n


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\"\u76f4\u51fbACLC<\/p>\n

\u4e2d\u56fd\u6297\u764c\u534f\u4f1a\u80ba\u764c\u4e13\u4e1a\u59d4\u5458\u4f1a\u4e3b\u4efb\u59d4\u5458\u3001<\/strong><\/span><\/p>\n

\u4e0a\u6d77\u4ea4\u901a\u5927\u5b66\u9644\u5c5e\u80f8\u79d1\u533b\u9662\u80bf\u7624\u79d1\u4e3b\u4efb\u9646\u821c\u6559\u6388<\/strong><\/span><\/p>\n


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\u3000\u3000\u5206\u5b50\u9776\u5411\u836f\u7269\u5bf9\u4e8e\u6709\u7279\u5b9a\u9a71\u52a8\u57fa\u56e0\u7a81\u53d8\u7684\u60a3\u8005\u5f88\u6709\u6548\u3002\u4ee5\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09\u4e3a\u4f8b\uff0c\u5177\u6709\u4e0d\u540c\u7684\u5206\u5b50\u4e9a\u578b\uff0c\u5bf9\u60a3\u8005\u7684\u4e2a\u6027\u5316\u6cbb\u7597\u5e94\u5f53\u91c7\u53d6\u4e0e\u5206\u5b50\u4e9a\u578b\u5339\u914d\u76f8\u5bf9\u5e94\u7684\u9776\u5411\u7597\u6cd5\u3002<\/p>\n


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\u3000\u3000\u5229\u7528\u57fa\u4e8e\u4e8c\u4ee3\u6d4b\u5e8f\uff08NGS\uff09\u7684ctDNA\u6280\u672f\uff0c\u4e0d\u4ec5\u53ef\u4ee5\u68c0\u6d4b\u51fa\u88ab\u8ba4\u4e3aNSCLC\u6cbb\u7597\u6700\u6709\u6548\u9776\u70b9\u7684EGFR\u7a81\u53d8\u548cALK\u878d\u5408\u7a81\u53d8\uff0c\u8fd8\u53ef\u4ee5\u4ece\u60a3\u8005\u8840\u6db2\u83b7\u5f97ROS1\uff0cBRAF\uff0cMET\uff0cRET\uff0cNTRK1\/2\/3\uff0cHER2\u7684\u7a81\u53d8\u4fe1\u606f\uff0c\u8fdb\u800c\u5229\u7528\u8fd9\u4e9b\u7a81\u53d8\u4fe1\u606f\u9009\u62e9\u5408\u9002\u7684\u9776\u5411\u7597\u6cd5\u3002\u800c\u5bf9\u4e8e\u65e0\u6cd5\u91c7\u53d6\u7cbe\u51c6\u533b\u7597\u7b56\u7565\u7684\u9a71\u52a8\u57fa\u56e0\u91ce\u751f\u578b\u7684\u60a3\u8005\uff0c \u5219\u53ef\u5728\u53c2\u8003PD-L1\u3001TMB\u4e24\u4e2a\u6807\u5fd7\u7269\u7684\u57fa\u7840\u4e0a\uff0c\u91c7\u53d6\u5316\u7597\u6216\uff08\u548c\uff09\u514d\u75ab\u6cbb\u7597\u7b49\u6807\u51c6\u6cbb\u7597\u3002<\/p>\n


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\u3000\u3000\u4e0d\u8fc7\uff0c\u7531\u4e8e\u5404\u79cd\u539f\u56e0\uff0c\u76ee\u524d\u4e34\u5e8a\u5b9e\u8df5\u4e2d\u80ba\u764c\u7ec4\u7ec7\u6807\u672c\u68c0\u6d4b\u7387\u4e0d\u9ad8\uff0c\u5bfc\u81f4\u57fa\u4e8e\u9a71\u52a8\u57fa\u56e0\u53d8\u5f02\u9776\u70b9\u7684\u4e2a\u4f53\u5316\u6cbb\u7597\u7b56\u7565\u96be\u4ee5\u5b9e\u65bd\u3002\u800c\u6db2\u4f53\u6d3b\u68c0\u4ee5\u5176\u5feb\u6377\u3001\u4fb5\u5bb3\u6027\u5c0f\u3001\u6210\u672c\u66f4\u4f4e\u3001\u53ef\u4ee5\u514b\u670d\u80bf\u7624\u7684\u5f02\u8d28\u6027\uff0c\u4ee5\u53ca\u53ef\u4ee5\u52a8\u6001\u76d1\u6d4b\u72ec\u7279\u7684\u4f18\u52bf\uff0c\u88ab\u8d8a\u6765\u8d8a\u591a\u5730\u8fd0\u7528\u5230\u4e34\u5e8a\u5b9e\u8df5\u4e2d\u3002<\/p>\n


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\u3000\u3000\u56e0\u6b64\uff0c\u4e34\u5e8a\u5b9e\u8df5\u65f6\u4e24\u79cd\u6a21\u5f0f\u66f4\u591a\u662f\u4e92\u8865\u5f0f\u7684\u5b58\u5728\u3002\u6216\u7ec4\u7ec7\u6d3b\u68c0\u57fa\u56e0\u68c0\u6d4b\u5148\u884c\uff0c\u6db2\u4f53\u6d3b\u68c0\u4f5c\u4e3a\u8865\u5145\uff1b\u6216\u6db2\u4f53\u6d3b\u68c0\u5148\u884c\uff0c\u7ec4\u7ec7\u6d3b\u68c0\u68c0\u6d4b\u4f5c\u4e3a\u8865\u5145\u3002<\/p>\n


<\/p>\n

\u3000\u3000\u5c31\u6db2\u4f53\u6d3b\u68c0\u800c\u8a00\uff0c\u5305\u62ec\u6b27\u7f8e\u3001\u4e2d\u56fd\u5728\u5185\u7684\u591a\u56fd\u653f\u5e9c\u6279\u51c6\u6db2\u4f53\u6d3b\u68c0\u3002\u5982\u7f8e\u56fdFDA\u6279\u51c6\u9996\u4e2aEGFR\u57fa\u56e0\u7a81\u53d8\u8840\u6db2\u68c0\u6d4b\u65b9\u6cd5\u2014\u2014\u7f57\u6c0fcobas EGFR Mutation Test v2\uff0c\u7528\u4e8e\u68c0\u6d4b\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09\u60a3\u8005EGFR\u5916\u663e\u5b5019\u7f3a\u5931\u548c\u5916\u663e\u5b5021\u7684 L858R\u66ff\u4ee3\u7a81\u53d8\u3002\u800c\u539f\u56fd\u5bb6\u98df\u54c1\u836f\u54c1\u76d1\u7763\u7ba1\u7406\u603b\u5c40\u57282015\u5e742\u6708\u5df2\u6279\u51c6\u5409\u975e\u66ff\u5c3c\u8bf4\u660e\u4e66\u66f4\u65b0\uff0c\u5728\u63a8\u8350\u6240\u6709NSCLC\u60a3\u8005\u7684\u80bf\u7624\u7ec4\u7ec7\u90fd\u5e94\u8fdb\u884cEGFR\u57fa\u56e0\u7a81\u53d8\u68c0\u6d4b\u57fa\u7840\u4e0a\uff0c\u5982\u679c\u80bf\u7624\u6807\u672c\u4e0d\u53ef\u8bc4\u4f30\uff0c\u5219\u53ef\u4f7f\u7528\u4ece\u8840\u6db2\uff08\u8840\u6d46\uff09\u6807\u672c\u4e2d\u83b7\u5f97\u7684ctDNA\u8fdb\u884c\u8bc4\u4f30\u3002<\/p>\n


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\u3000\u3000\u8fd1\u5e74\u4ea6\u6709\u591a\u9879\u7814\u7a76\u8bc1\u660e\uff0cctDNA\u5728EGFR\u7a81\u53d8\u68c0\u6d4b\u4e0a\u5177\u6709\u7279\u5f02\u6027\u3001\u654f\u611f\u6027\u3001\u4e0e\u7ec4\u7ec7\u7ed3\u679c\u4e00\u81f4\u6027\uff0cctDNA\u53ef\u4f5c\u4e3a\u8bc4\u4f30EGFR\u7a81\u53d8\u72b6\u6001\u7684\u66ff\u4ee3\u6307\u6807\u3002\u56e0\u6b64\uff0c\u63a2\u7d22\u9ad8\u654f\u611f\u8840\u6db2\u68c0\u6d4b\u5e73\u53f0\u4f5c\u4e3a\u7ec4\u7ec7\u68c0\u6d4b\u5bf9\u6709\u6548\u8865\u5145\uff0c\u6210\u4e3a\u8fd1\u671f\u7814\u7a76\u8005\u5173\u6ce8\u7684\u91cd\u70b9\u3002<\/p>\n


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\u3000\u3000\u4e00\u9879\u91c7\u7528Cobas\u3001Super-ARMS\u3001\u6570\u5b57PCR\u548cNGS\u6cd5\u68c0\u6d4b\u4e2d\u56fd\u665a\u671f\u6216\u8f6c\u79fb\u6027NSCLC\u53d7\u8bd5\u8005ctDNA\u4e2d\u7684EGFR T790M\u7a81\u53d8\u72b6\u6001\u7684\u7814\u7a76\u53d1\u73b0\uff0c\u5bf9\u4e8eT790M\u7a81\u53d8NGS\u5e73\u53f0\u8868\u73b0\u51fa\u6700\u9ad8\u7684\u4e00\u81f4\u6027\u548c\u654f\u611f\u6027\uff0c\u800ccobas\u5219\u8868\u73b0\u51fa\u6700\u9ad8\u7684\u7279\u5f02\u6027\u3002<\/p>\n


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\u8ffd\u8e2a\u8010\u836f\u7a81\u53d8<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


<\/p>\n

\u3000\u3000T790M\u7a81\u53d8\u662f\u76ee\u524d\u4e00\u4e8c\u4ee3EGFR TKI\u6700\u4e3b\u8981\u7684\u8010\u836f\u673a\u5236\u30022017\u5e74\u7684\u4e00\u9879\u7814\u7a76\u8868\u660eT790M\u5360\u8010\u836f\u4eba\u53e3\u768461%\u3002\u8010\u836f\u540eT790M\u7a81\u53d8\u4e0e\u5426\uff0c\u4e0e\u60a3\u8005\u63a5\u53d7\u4e00\u7ebf\u6216\u4e8c\u7ebfTKI\u6cbb\u7597\u7684\u7597\u6548\u6301\u7eed\u65f6\u95f4\u76f4\u63a5\u76f8\u5173\u3002\u5bf9\u4e8e\u8010\u836f\u540e\u7684\u60a3\u8005\uff0cT790M\u9633\u6027\u60a3\u8005\u63a5\u53d7\u4e09\u4ee3EGFR TKI\u6cbb\u7597\u7684\u7597\u6548\u663e\u8457\u4f18\u4e8eT790M\u9634\u6027\u7684\u60a3\u8005\u3002<\/p>\n


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\u3000\u3000ALK\u6291\u5236\u5242\u7ee7\u53d1\u8010\u836f\u6d89\u53caALK\u916a\u6c28\u9178\u6fc0\u9176\u57df\u7684\u70b9\u7a81\u53d8\u3002\u7814\u7a76\u8bc1\u5b9e\u4e0d\u540cALK\u6291\u5236\u5242\u7684\u8010\u836f\u673a\u5236\u4e0d\u540c\u3002ALK\u8010\u836f\u7a81\u53d8\u5728\u4e8c\u4ee3\u836f\u7269\u4e2d\u66f4\u4e3a\u5e38\u89c1\u3002\u7531\u4e8eALK\u4e8c\u6b21\u7a81\u53d8\u662f\u4e8c\u4ee3ALK\u6291\u5236\u5242\u7684\u5e38\u89c1\u8010\u836f\u673a\u5236\uff0c\u662f\u4e09\u4ee3ALK\u6291\u5236\u5242\u654f\u611f\u6027\u7684\u9884\u6d4b\u56e0\u5b50\uff0c\u56e0\u6b64\u66f4\u9700\u8981\u5f3a\u8c03\u4e86\u9776\u5411\u6cbb\u7597\u8fdb\u5c55\u540e\u91cd\u590d\u6d3b\u68c0\u548c\u57fa\u56e0\u5206\u578b\u7684\u91cd\u8981\u6027\u3002<\/p>\n


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\u3000\u3000\u9646\u821c\u6307\u51fa\uff0c\u8003\u8651\u5230\u91cd\u590d\u6d3b\u68c0\u96be\u5ea6\u8f83\u9ad8\uff0c\u4e14\u963b\u529b\u53ef\u80fd\u662f\u5f02\u8d28\u7684\uff0c\u56e0\u6b64\u975e\u4fb5\u5165\u6027\u6280\u672f\uff08\u5982ctDNA\uff09\u7684\u5f00\u53d1\u548c\u9a8c\u8bc1\u81f3\u5173\u91cd\u8981\u3002<\/p>\n


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\u52a8\u6001\u76d1\u6d4b\u6cbb\u7597<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n


<\/p>\n

\u3000\u3000\u6b64\u5916\uff0cctDNA \u7528\u4e8e\u80bf\u7624\u7597\u6548\u8bc4\u4f30\u548c\u9884\u540e\u76d1\u6d4b\u7684\u4f18\u52bf\u4e5f\u5728\u591a\u4e2a\u4e34\u5e8a\u5b9e\u9a8c\u4e2d\u5f97\u5230\u4e86\u8bc1\u5b9e\u3002<\/p>\n


<\/p>\n

\u3000\u3000\u76ee\u524d\u6db2\u4f53\u6d3b\u68c0\u5df2\u8fdb\u5165NSCLC\u7684\u4e34\u5e8a\u5b9e\u8df5\u3002\u201c\u9700\u6ce8\u610f\u7684\u662f\uff0c\u5728\u8bca\u65ad\u665a\u671fNSCLC\u65f6\uff0c\u7ec4\u7ec7\u6807\u672c\u68c0\u6d4b\u4ecd\u662f\u5206\u5b50\u5206\u578b\u7684\u91d1\u6807\u51c6\u3002\u201d<\/strong>\u9646\u821c\u5f3a\u8c03\u9053\uff0c\u7531\u4e8e\u4e0e\u80bf\u7624\u7ec4\u7ec7\u76f8\u6bd4\uff0cctDNA\u4e2d\u57fa\u56e0\u7a81\u53d8\u68c0\u6d4b\u5177\u6709\u9ad8\u5ea6\u7279\u5f02\u6027\u548c\u76f8\u5bf9\u8f83\u4f4e\u7684\u654f\u611f\u5ea6\uff0c\u82e5\u8840\u6db2\u57fa\u56e0\u7a81\u53d8\u68c0\u6d4b\u7ed3\u679c\u4e3a\u9634\u6027\uff0c\u4ecd\u9700\u505a\u80bf\u7624\u7ec4\u7ec7\u6d3b\u68c0\uff0c\u4ee5\u786e\u5b9a\u662f\u5426\u5b58\u5728\u76f8\u5e94\u7684\u57fa\u56e0\u7a81\u53d8\u3002<\/p>\n


<\/p>\n

\u3000\u3000\u9646\u821c\u8868\u793a\uff0c\u6cbb\u7597\u671f\u95f4ctDNA\u6c34\u5e73\u7684\u52a8\u6001\u53d8\u5316\u53ef\u6709\u6548\u8bc4\u4f30\u7597\u6548\u53ca\u9884\u6d4b\u590d\u53d1\uff0c\u80fd\u66f4\u597d\u5730\u6307\u5bfc\u4e34\u5e8a\u4e2a\u6027\u5316\u8bca\u7597\u3002<\/p>\n


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