合并恶性胸腔积液的晚期肺腺癌患者胸水表皮生长因子受体基因突变检测  

Detection of epidermal growth factor receptor mutation in advanced lung adenocarcinoma patients with malignant pleural effusion

作　　者：胡述提[1] 金冰[1] 林涛[1] 

机构地区：[1]河南省南阳市中心医院胸外科,473009

出　　处：《中华实验外科杂志》2015年第4期900-902,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨利用恶性胸腔积液（MPE）对晚期肺腺癌患者进行表皮生长因子受体（EGFR）基因突变检测的可行性.方法 收集41例合并恶性胸腔积液的肺腺癌患者的肿瘤组织和与其配对的胸水标本,利用扩增阻遏突变系统（ARMS）检测EGFR基因18、19和21外显子的突变,分析不同样本EGFR基因突变检测结果的关系.结果 41例晚期肺腺患者肿瘤组织中检测EGFR基因突变,突变率为53.7％ （22/41）.41例患者配对的恶性胸腔积液中脱落细胞标本和胸水上清液,EGFR基因突变检测阳性率分别为51.2％ （21/41）和41.5％（17/41）.和肿瘤组织样本比较,与其配对的胸水脱落细胞样本和胸水上清液检测EGFR基因突变的灵敏度分别为81.8％ （18/22）和72.7％ （16/22）,特异度分别为84.2％ （16/19）和94.7％ （18/19）.结论 对于肿瘤组织标本不易获得的晚期肺腺癌患者,其恶性胸水中的脱落细胞和胸水上清液可作为检测EGFR基因突变状态的较为可信的替代检测样本.Objective To evaluate the feasibility of malignant pleural effusion （MPE） as substitute samples for epidermal growth factor receptor （EGFR） mutation detection.Methods Forty-one cases of tumor tissue samples and their paired MPE （including desquamate cell and supernatant） from lung adenocarcinoma patients were collected.EGFR mutations in exons 18,19 and 21 were assessed by scorpions and amplification refractory mutation system [scorpions amplification refractory mutation system （ARMS）].The sensitivity,specificity and accuracy of different samples of MPE were assessed versus tumor tissue samples.Results EGFR somatic mutations were detected in 22 of 41 advanced lung adenocarcinoma patients,with the mutation rate of 53.7%.The EGFR gene mutations in 41 patients were detected in paired chest hydrocele desquamate cell and paired MPE supernatant,and EGFR mutation positive rate in these two types of tumor samples was 51.2% （21/41） and 41.5% （17/14,P 〉0.05） respectively.Sensitivity of MPE desquamate cells,and MPE supernatant versus tissue was 81.8% （18/22） and 72.7% （16/22） ; specificity was 84.2% （16/19） and 94.7% （18/19）,respectively.Conclusion MPE desquamate cells and MPE supernatant are efficient substitutes for EGFR mutation detection in advanced lung adenocarcinoma patients when tissue is not available.

关 键 词：恶性胸腔积液 表皮生长因子受体 肺腺癌 

分 类 号：R734.2[医药卫生—肿瘤]