{"id":9099,"date":"2020-05-27T12:00:40","date_gmt":"2020-05-27T04:00:40","guid":{"rendered":"http:\/\/mp.weixin.qq.com\/s?__biz=MzI3NjUzOTM1Mg==&mid=100013510&idx=1&sn=4d2684e323776c4b87e49c77b21bd376&chksm=6b7147715c06ce67823ffe59fd725a0255975cd3b180e97942c615657f0576d1f497982af36d#rd"},"modified":"2026-04-08T09:55:06","modified_gmt":"2026-04-08T01:55:06","slug":"5510056","status":"publish","type":"post","link":"https:\/\/www.geneclub.net.cn\/index.php\/2020\/05\/27\/5510056\/","title":{"rendered":"\u6bcf\u5e74\u8d8512\u4e07\u60a3\u8005\uff01\u4e00\u6587\u901f\u89c8\u80bf\u7624\u57fa\u56e0\u878d\u5408\uff0c\u6700\u65b0\u68c0\u6d4b\u6807\u51c6\u54c1\u53d1\u5e03"},"content":{"rendered":"

<\/p>\n

\u80bf\u7624\u7cbe\u51c6\u6cbb\u7597\u7684\u5185\u6838\u4e4b\u4e00\uff0c\u662f\u901a\u8fc7\u57fa\u56e0\u68c0\u6d4b\u6700\u5927\u5316\u5339\u914d\u9776\u5411\u7528\u836f\u3002\u540c\u65f6\u5f88\u591a\u95ee\u9898\u4ecd\u5f85\u89e3\u51b3\u3002\u4f8b\u5982\uff0c\u6bcf\u5e74\u65b0\u53d1\u8d8512\u4e07\u540d\u643a\u5e26\u878d\u5408\u7a81\u53d8\u7684\u80ba\u817a\u764c\u60a3\u8005\u3002\u867d\u7136\u9776\u5411\u836f100%\u8986\u76d6\uff0c\u5982\u4f55\u786e\u4fdd\u4e34\u5e8a\u57fa\u56e0\u68c0\u6d4b\u62a5\u544a\u7684\u516c\u4fe1\u529b\uff1f\u6807\u51c6\u5316\u7ba1\u7406\u548c\u8d28\u63a7\u662f\u5173\u952e\u3002\u672c\u6587\u901f\u89c8\u4ece\u80bf\u7624\u878d\u5408\u57fa\u56e0\u3001\u9776\u5411\u836f\u5230\u4f34\u968f\u8bca\u65ad\u5230\u6700\u65b0\u878d\u5408\u68c0\u6d4b\u6807\u51c6\u54c1\u3002<\/div>\n
\u6587\u7ae0 | \u83c1\u826f\u57fa\u56e0\u7f16\u8f91 | \u57fa\u56e0\u6167<\/div>\n
\u5173\u952e\u8bcd | \u878d\u5408\u57fa\u56e0\u00a0 \u6807\u51c6\u54c1<\/div>\n\n
\n
\"RmFicvQBAkgCtUIdVSriaJ0X95JcictoYFicribpOJHuOfvCy20IEoeUukPOb5G0JRXoeIAia7I8mDK1YongiakRG2VRg\"\/<\/figure><\/div>\n\n
\u25b3 \u80ba\u764c\u5206\u578b\uff08\u6765\u6e90\/clinical care oncology\uff09<\/div>\n
\u25a0 \u80ba\u817a\u764c\u7684\u4e3b\u8981\u878d\u5408\u57fa\u56e0\u53ca\u9891\u7387<\/div>\n
\u6211\u56fd\u6bcf\u5e74\u65b0\u53d1\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09\u60a3\u8005\u7ea680\u4e07\uff0c\u9884\u8ba1\u670912\u4e07\u60a3\u8005\u643a\u5e26\u57fa\u56e0\u878d\u5408\u7a81\u53d8\u3002\u4e34\u5e8a\u6570\u636e\u7814\u7a76\u53d1\u73b0\uff0c\u57fa\u56e0\u878d\u5408\u5728NSCLC\u817a\u764c\u7684\u57fa\u56e0\u7a81\u53d8\u5360\u6bd4\u4e2d\u4ec5\u6b21\u4e8eKRAS\u548cEGFR\uff0c\u5c5e\u4e8e\u7b2c\u4e09\u5927\u7c7b\u7a81\u53d8\u3002\u878d\u5408\u5408\u5e76\u7a81\u53d8\u9891\u7387\u7ea6\u4e3a15%\u3002<\/div>\n
NSCLC\u4e2d\u7684\u80ba\u817a\u764c\u662f\u9776\u5411\u6cbb\u7597\u6bd4\u8f83\u591a\u7684\u764c\u79cd\u7c7b\u578b\uff0c\u5176\u4e2d\u6709\u54ea\u4e9b\u57fa\u56e0\u878d\u5408\u7a81\u53d8\u7684\u4e3b\u8981\u7c7b\u578b\u5462\uff1f\u672c\u6587\u68b3\u7406\u5982\u4e0b\uff08\u53c2\u8003\u6587\u732e\u89c1\u6587\u672b\uff09\uff1a<\/div>\n
\u00a0<\/div>\n
1\uff09ALK\u57fa\u56e0+EML4\u57fa\u56e0<\/div>\n
\u7a81\u53d8\u5728\u8fd9\u4e2a\u764c\u79cd\u7c7b\u578b\u4e2d\u6bd4\u4f8b\u662f5%-8%\u3002\u5bf9\u4e8e\u4e9a\u88d4\u7684EGFR\u3001KRAS\u91ce\u751f\u578b\u7684\u817a\u764c\u60a3\u8005\uff0cALK\u9633\u6027\u6bd4\u4f8b\u9ad8\u8fbe30%-42%\u3002ALK\u57fa\u56e0\u6700\u5e38\u89c1\u7684\u878d\u5408\u4f34\u4fa3\u57fa\u56e0\u662fEML4\uff0cEML4\u548cALK\u4e2d\u6700\u5e38\u89c1\u7684\u7a81\u53d8\u4e9a\u4f53\u662f3a\/b\uff0c\u5360\u6bd4\u662f33.34%\u3002EML4-ALK\u7a81\u53d8\u4f531\u548c\u7a81\u53d8\u4f532\u5206\u522b\u5360\u6bd423.33%\u548c15%\u3002<\/div>\n
2\uff09ROS1\u57fa\u56e0\u7a81\u53d8<\/div>\n
ROS1\u91cd\u6392\u9633\u6027\u53ea\u5360\u975eNSCLC\u4eba\u7fa4\u76841%-2%, \u5176\u4e2d32%\u4e3aCD47-ROS1\u878d\u5408\u3002\u5728\u6211\u56fd\uff0c\u6bcf\u5e74\u65b0\u53d1\u7684\u80ba\u764c\u60a3\u8005\u670970-80\u4e07\uff0c\u6309\u7167\u53d1\u75c5\u9891\u7387\u9884\u4f30\u6bcf\u5e74\u67097000-8000\u7684\u60a3\u8005\u5b58\u5728ROS1\u57fa\u56e0\u7a81\u53d8\u3002\u00a0<\/div>\n
3\uff09NTRK\u57fa\u56e0\u7a81\u53d8<\/div>\n
NTRK\u66f4\u5e38\u89c1\u4e8e\u7f55\u89c1\u7684\u764c\u75c7\uff0c\u5982\u5a74\u513f\u578b\u8089\u7624\uff0c\u5374\u5f88\u5c11\u5b58\u5728\u4e8e\u5e38\u89c1\u7684\u764c\u75c7\u3001\u5982NSCLC\u3002\u76f8\u5173\u57fa\u56e0\u9891\u7387\u6570\u636e\u5982\u4e0b\uff1aNTRK1 \u80ba\u817a\u764c 3.3%\uff0c\u7ed3\u76f4\u80a0\u764c1.5%\uff1bNTRK2 \u80ba\u817a\u764c0.2%\uff1bNTRK3 \u7ed3\u76f4\u80a0\u764c0.7%\u3001\u5c0f\u513f\u795e\u7ecf\u80f6\u8d28\u76247.1%\u3002\u00a0<\/div>\n
4\uff09RET\u57fa\u56e0\u878d\u5408<\/div>\n
RET\u57fa\u56e0\u878d\u5408\u901a\u5e38\u51fa\u73b0\u5728\u7ea62\uff05\u7684NSCLC\u300110-20\uff05\u7684\u4e73\u5934\u72b6\u7532\u72b6\u817a\u764c\uff08PTC\uff09\u53ca<1%\u7684\u5176\u5b83\u764c\u75c7\u4e2d\u3002RET\u878d\u5408\u7684\u4f34\u4fa3\u57fa\u56e0\u4e3b\u8981\u662fKIF5B\u3001CCDC6\u3001NCOA4\u548cTRIM33\uff0c\u5176\u4e2d\u4e3b\u8981\u4e3aKIF5B\u3002KIF5B-RET\u6709\u591a\u79cd\u878d\u5408\u5f62\u5f0f\uff0c\u5176\u4e2d75%\u4ee5\u4e0a\u7684KIF5B-RET\u878d\u5408\u4e3aK15;R12\u3002\u00a0<\/div>\n
5\uff09MET\u57fa\u56e0<\/div>\n
MET\u57fa\u56e014 \u5916\u663e\u5b50\u8df3\u8dc3\u7a81\u53d8\u591a\u53d1\u751f\u4e8eNSCLC\uff0c\u5e76\u4ee5\u5176\u4e2d\u7684\u80ba\u8089\u7624\u6837\u764c\u548c\u817a\u764c\u66f4\u591a\u89c1\uff0c\u5728\u80ba\u817a\u764c\u4e2d\u7684\u53d1\u751f\u7387\u7ea63~4%\uff0c\u5728\u80ba\u8089\u7624\u6837\u764c\u4e2d\u7684\u53d1\u751f\u7387\u53ef\u9ad8\u8fbe22%\u30022020\u5e745\u6708\uff0c\u7f8e\u56fdFDA\u6279\u51c6\u4e86\u9488\u5bf9\u8fd9\u4e00\u7279\u5b9a\u60a3\u8005\u7fa4\u7684\u9996\u6b3e\u9776\u5411\u7597\u6cd5Tabrecta\uff08capmatinib\uff09\uff0c\u6cbb\u7597\u643a\u5e26MET\u57fa\u56e0\u5916\u663e\u5b5014\u8df3\u8dc3\u7a81\u53d8\u7684\u665a\u671fNSCLC\u60a3\u8005\u3002<\/div>\n
\u25a0 \u5e38\u89c1\u878d\u5408\u7a81\u53d8\u7684\u9776\u5411\u836f\u5df2\u8986\u76d6100%<\/div>\n\n
\n
\"640?wx_fmt=png\"\/<\/figure><\/div>\n\n
\u25b3 \u57fa\u56e0\u878d\u5408\u7a81\u53d8\u7684\u9776\u5411\u836f\uff08\u6765\u6e90\/\u533b\u4e16\u8c61\uff09<\/div>\n
\u4eba\u4eec\u5df2\u7ecf\u9501\u5b9a\u4e86\u5927\u7ea62\u4e07\u591a\u4e2a\u878d\u5408\u57fa\u56e0\uff0c\u4f46\u662f\u5b83\u4eec\u5728\u764c\u75c7\u53d1\u5c55\u4e2d\u7684\u786e\u5207\u529f\u80fd\u548c\u4f5c\u7528\u5219\u77e5\u4e4b\u751a\u5c11\u3002\u56e0\u6b64\uff0c\u8fa8\u522b\u878d\u5408\u57fa\u56e0\u662f\u5426\u4e0e\u764c\u75c7\u75c5\u4eba\u7684\u9884\u540e\u76f8\u5173\u5177\u6709\u91cd\u8981\u7684\u4e34\u5e8a\u610f\u4e49\u3002<\/div>\n
\u622a\u81f3\u52302020\u5e745\u67088\u65e5RET\u9776\u5411\u836fLOXO-292\u83b7\u6279\uff0c\u5e38\u89c1\u878d\u5408\u7a81\u53d8\u7684\u9776\u5411\u836f\u5df2\u8986\u76d6100%\u3002\u878d\u5408\u7a81\u53d8\u867d\u7136\u4f4e\u9891\uff0c\u4f46\u9776\u5411\u836f\u9884\u540e\u597d\uff0c\u4e14\u53ef\u5e8f\u8d2f\u7528\u836f\u3002<\/div>\n
\u00a0<\/div>\n
\u25a0\u00a0\u591a\u79cd\u878d\u5408\u57fa\u56e0\u68c0\u6d4b\u7eb3\u5165NCCN\u6307\u5357<\/div>\n
\u76ee\u524d\u5df2\u7ecf\u6709\u591a\u79cd\u878d\u5408\u57fa\u56e0\u68c0\u6d4b\u5df2\u88ab\u7eb3\u5165NCCN\u6307\u5357\u5e38\u89c4\u63a8\u8350\u3002\u4f8b\u5982\u57282020\u7248\u7684\u300a\u975e\u5c0f\u7ec6\u80de\u80ba\u764cNCCN\u6307\u5357\u300b\u4e2d\u660e\u786e\u6307\u51fa\uff0c\u5bf9\u4e8e\u901a\u8fc7\u591a\u57fa\u56e0NGS \u68c0\u6d4b\u672a\u53d1\u73b0\u9a71\u52a8\u57fa\u56e0\u7a81\u53d8\u7684\u60a3\u8005\uff0c\u5efa\u8bae\u884cRNA-NGS\u68c0\u6d4b\uff0c\u4ece\u800c\u66f4\u5927\u7a0b\u5ea6\u5730\u53d1\u73b0\u878d\u5408\u4e8b\u4ef6\u3002<\/div>\n
\u57282020\u7248\u300a\u7ed3\u76f4\u80a0\u764cNCCN\u6307\u5357\u300b\u4e2d\uff0c\u4e13\u5bb6\u5efa\u8bae\u5bf9\u4e8e\u5df2\u7528IHC\u68c0\u6d4bNTRK\u878d\u5408\u9633\u6027\u7684\u60a3\u8005\uff0c\u7531\u4e8e\u68c0\u6d4b\u65b9\u6cd5\u7684\u5c40\u9650\u6027\u53ef\u80fd\u5b58\u5728\u5047\u9633\u6027\u7387\u9ad8\u7684\u73b0\u8c61\uff0c\u6545\u800c\u63a8\u8350\u518d\u7528RNA-NGS\u786e\u8bca\u3002<\/div>\n
NCCN\u6307\u5357\u7684\u63a8\u8350\u4f53\u73b0\u51fa\u4e86\u878d\u5408\u57fa\u56e0\u68c0\u6d4b\u7684\u91cd\u8981\u6027\uff0c\u901a\u8fc7\u878d\u5408\u68c0\u6d4b\u6700\u5927\u5316\u7684\u5339\u914d\u9776\u5411\u7528\u836f\uff0c\u5df2\u7ecf\u6210\u4e3a\u80bf\u7624\u7cbe\u51c6\u6cbb\u7597\u7684\u4e2d\u6d41\u7825\u67f1\u3002<\/div>\n
\u968f\u7740\u9776\u5411\u836f\u7684\u4e0a\u5e02\uff0c\u4e5f\u6709\u8d8a\u6765\u8d8a\u591a\u7684\u4f34\u968f\u8bca\u65ad\u68c0\u6d4b\u8bd5\u5242\u76d2\u88abFDA\u548cNMPA\u6279\u51c6\uff0c<\/div>\n
\u76ee\u524d\uff0c\u878d\u5408\u57fa\u56e0\u7684\u68c0\u6d4b\u65b9\u6cd5\u5305\u62ec\u4f20\u7edf\u7684\u8367\u5149\u539f\u4f4d\u6742\u4ea4\uff08FISH\uff09\u3001PCR\u6269\u589e\u6280\u672f\uff08RT-PCR\uff09\u3001\u514d\u75ab\u7ec4\u5316\uff08IHC\uff09\u4ee5\u53caNGS\u7b49\u6280\u672f\u3002\u6bcf\u79cd\u6280\u672f\u90fd\u5404\u6709\u4f18\u52a3\u52bf\u3002\u4f46\u662f\u5728RNA\u6c34\u5e73\u4e0a\u884cNGS\u68c0\u6d4b\u878d\u5408\u57fa\u56e0\u76f8\u8f83\u4e8eDNA\u6c34\u5e73\u4e0a\u5929\u7136\u5b58\u5728\u5404\u79cd\u4f18\u52bf\u3002RNA\u6c34\u5e73\u878d\u5408\u7684\u9776\u57fa\u56e0\u529f\u80fd\u76f8\u5173\u6027\u66f4\u5f3a\u3002<\/div>\n
\u00a0<\/div>\n
\u25a0 \u786e\u4fdd\u4e34\u5e8a\u62a5\u544a\u7684\u516c\u4fe1\u529b\uff1f\u6700\u65b0\u80bf\u7624\u878d\u5408\u6807\u51c6\u54c1\u52a9\u529b<\/div>\n
\u6280\u672f\u9769\u65b0\u548c\u53d1\u5c55\u4e3a\u4e34\u5e8a\u5206\u5b50\u68c0\u6d4b\u5e73\u53f0\u5f00\u62d3\u66f4\u5927\u7684\u53d1\u5c55\u7a7a\u95f4\u548c\u5e94\u7528\u4ef7\u503c\uff0c\u4f46\u540c\u65f6\u4f34\u968f\u800c\u6765\u7684\u662f\u68c0\u6d4b\u9519\u8bef\u7387\u548c\u95ee\u9898\u590d\u6742\u6027\u3002\u6807\u51c6\u5316\u7ba1\u7406\u548c\u8d28\u91cf\u63a7\u5236\u662f\u4fdd\u8bc1\u7ed3\u679c\u51c6\u786e\u7684\u5fc5\u8981\u6761\u4ef6\u3002\u83c1\u826f\u57fa\u56e0\u878d\u5408\u6807\u51c6\u54c1\u7684\u4f7f\u7528\u53ef\u4ee5\u786e\u4fdd\u4e34\u5e8a\u5206\u5b50\u68c0\u6d4b\u9879\u76ee\u5728\u533b\u9662\u7684\u6709\u5e8f\u5f00\u5c55\uff0c\u4e0d\u540c\u7c7b\u578b\u7684\u6807\u51c6\u54c1\u7684\u7ec4\u5408\u642d\u914d\u4f7f\u7528\u53ef\u4ee5\u6ee1\u8db3\u5f53\u4e0b\u4e34\u5e8a\u9700\u6c42\uff0c\u786e\u4fdd\u4e34\u5e8a\u62a5\u544a\u7684\u516c\u4fe1\u529b\u3002<\/div>\n\n
\n
\"RmFicvQBAkgCtUIdVSriaJ0X95JcictoYFicX9aZaxLroKXGZw4xibc0r68DXdsXhGNiblLm1DuBia6oPPXdzho9r9vcA\"\/<\/figure><\/div>\n\n
\u25b3 \u80bf\u7624\u878d\u5408FFPE\u6807\u51c6\u54c1\u7684\u4f4d\u70b9\u4fe1\u606f\uff08\u6765\u6e90\/\u83c1\u826f\u57fa\u56e0\uff09<\/div>\n
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\u53c2\u8003\u8d44\u6599\uff1a<\/div>\n
1. ALK Gene Rearrangements\uff1aA New Therapeutic Target in a Molecularly Defined Subset of Non-small Cell Lung Cancer\uff0cGENE OF THE MONTH J Thorac Oncol. 2009;4: 1450\u20131454<\/div>\n
2. Updated Molecular Testing Guideline for\u00a0the Selection of Lung Cancer Patients for Treatment With Targeted Tyrosine Kinase Inhibitors\uff1bJournal of Thoracic Oncology<\/div>\n
3. Recent Advances in Targeting ROS1 in Lung Cancer\uff1bJournal of Thoracic Oncology Vol. 12 No. 11\uff1a611-1625<\/div>\n
4. Clinical and Translational Implications of RET\u00a0Rearrangements in Non\u2013Small Cell Lung Cancer\uff1bJournal of Thoracic Oncology Vol. 13 No. 1: 27-45<\/div>\n
5. MET Exon 14 Mutations in Non\u2013Small-Cell\u00a0Lung Cancer Are Associated With Advanced\u00a0Age and Stage-Dependent MET Genomic\u00a0Amplification and c-Met Overexpression\uff1bJ Clin Oncol 34:721-730.<\/div>\n
6. Non-Small Cell Lung\u00a0Cancer\uff1bNCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines\u00ae)<\/div>\n
7. Diagnosis of fusion genes using targeted RNA\u00a0sequencing\uff1bNATURE COMMUNICATIONS | https:\/\/doi.org\/10.1038\/s41467-019-09374-9\u00a02 NATURE<\/div>\n
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