p63与表皮生长因子受体突变肺鳞癌患者生存的关系  

Relationship between p63 expression and survival of squamous lung cancer patients with mutatant epidermal growth factor receptor

作　　者：王碧波[1] 韩一平[1] 万善志[1] 黄玲[2] 马大烈[2] 郑建明[2] 李强[1] 

机构地区：[1]第二军医大学长海医院呼吸内科,上海200433 [2]第二军医大学长海医院病理科,上海200433

出　　处：《第二军医大学学报》2014年第4期378-382,共5页Academic Journal of Second Military Medical University

摘　　要：目的 检测表皮生长因子受体（EGFR）在肺鳞癌患者中的突变率，并分析p63与EGFR突变肺鳞癌患者生存的关系。方法 收集2010年2月至2013年3月在我院初治的肺鳞癌患者的组织样本，用直接测序法检测EGFR突变情况，免疫组织化学法检测p63的表达。随访患者，记录患者的总生存时间（OS），评价EGFR突变和p63表达对患者生存的影响。结果 所有病理组织确诊为肺鳞癌的262例患者中，16例（6.1%）有EGFR突变 ，其中外显子19位点缺失7例，外显子21 L858R点突变9例，未见外显子18和20突变。与传统意义上的肺鳞癌患者相比，EGFR突变的肺鳞癌患者女性和非吸烟者所占比例较高。p63部分阳性的EGFR突变患者（n=4）的OS为11.28（95%CI：9.33～15.23）个月，p63阳性的EGFR突变患者（n=11）的OS 为5.93（95%CI：1.75～8.39）个月，两者差异有统计学意义（P=0.039）。结论 肺鳞癌患者EGFR突变率为6.1%，均为外显子19和21敏感突变。p63部分阳性的EGFR突变患者比p63阳性EGFR突变患者生存期更长。Objective To detect the mutation rate of epidermal growth factor receptor （EGFR） in squamous carcinoma （SQC） of lung and to exam the relationship between p63 and survival of SQC patients with EGFR mutation. Methods SQC specimens were collected from the patients who received their initial treatment in our hospital between February 2010 and March 2013. The incidence of EGFR mutations was analyzed by automated direct sequencing, and immunohistochemical method was used to observe p63 expression. The patients were followed up and the impact of EGFR mutation and p63 expression upon survival of SQC patients was evaluated. Results Among the 262 histological diagnosed SQC patients, 16 （6.1%） had EGFR mutations, including exon 19 deletion （7 of 16 patients, 43.8%） and L858R point mutation in exon 21 （9 of 16, 56.2%）, with no mutation of exon 18 and 20. SQC patients with EGFR mutations, compared with other SQC patients, had more females and non-smokers. The median overall survival （OS） time of 4 EGFR-mutated patients with p63 partial positive expression was 11.28 months （95% CI： 9.33-15.23 months）, which was significantly longer than that of 11 EGFR-mutated patients with p63 positive expression （5.93 months [95% CI： 1.75-8.39 months], P=0.039）. Conclusion EGFR mutation rate is 6.1% in our study, with all being exon 19 and 21 mutations. Patients presenting partial positive p63 expression have longer survival time than those presenting p63 positive expression.

关 键 词：P63 表皮生长因子受体 肺肿瘤 鳞状细胞癌 

分 类 号：R734.2[医药卫生—肿瘤]