非小细胞肺癌中EGFR和K-ras基因突变检测  

EGFR and K-ras gene mutation in non-small cell lung cancer

作　　者：金琳芳[1] 齐晓薇[1] 陆莲[1] 浦勇[1] 白瑞珍[1] 秦艳[1] 刘彦魁 

机构地区：[1]江南大学附属医院(无锡市第四人民医院)病理科,江苏无锡214000

出　　处：《现代肿瘤医学》2016年第8期1218-1221,共4页Journal of Modern Oncology

基　　金：无锡市医院管理中心项目基金(编号:YGZXM1540)

摘　　要：目的:探讨不同类型非小细胞肺癌的EGFR和K-ras基因突变情况及其与肺癌相关临床病理特征的关系。方法:用厦门艾德ADx ARMS试剂盒进行98例非小细胞肺癌患者肿瘤组织中EGFR(18,19,20,21外显子)基因和K-ras(12,13,61密码子)基因突变的检测。所有患者均未接受过吉非替尼的治疗。结果:98例样本中31例发生了EGFR基因突变,突变率为31.6%(31/98),其中15例为19外显子缺失,13例为21L858R外显子点突变,3例为20外显子突变,1例为18外显子突变。其中1例既有19外显子缺失突变,又有20外显子突变。腺癌中EGFR基因突变率较鳞癌、腺鳞癌、大细胞癌高。女性患者EGFR基因突变率较男性高。不吸烟患者EGFR基因突变率较吸烟患者高。低分化腺癌患者EGFR基因突变率较中、高分化患者高。21例发生了K-ras基因突变(21.4%),其中12、13、61密码子均发现突变。突变率腺癌较鳞癌、腺鳞癌、大细胞癌高,与是否吸烟、患者性别、分化程度均无相关性。结论:非小细胞肺癌患者EGFR基因突变检出率较高,K-ras基因突变率较低,且两者不存在同时突变,EGFR基因突变与肺癌组织学类型、分化程度、性别等相关。K-ras基因突变与组织学类型相关。Objective： To investigate the gene mutatio of EGFR and K-ras in different types of non-small cell lung cancer,and the relationship between mutations and pathological characteristics. Methods： Gene sequencing was used to detect the EGFR（ exons 18,19,20,21） and K-ras（ codons 12,13,61） gene mutation status in 98 patients with non-small cell lung cancer. All patients had not recieved treament of gefitinib. Results： In 98 patients,EGFR mutation rate was 31. 6%（ 31 /98）,15 patients had No. 19 deletion mutation,13 patients had No. 21 L858 R point mutation,3 patients had No. 20 mutation,1 patient had No. 18 mutation. 1 patient had not only No. 19 deletion mutation but also No. 20 mutation. Mutation rate was siganificantly higher in adenocarcinoma than in adeo-squmaous cacinoma,squmaous cell cacinoma and large cell carcinoma. And was siganificantly higher in femal than in male,in non-smoking than in smoking. In adenocarcinoma,mutation rate was higher in poorly differentiated carcinoma than in medium and well differentiated carcinoma. K-ras mutation rate was 21. 4%（ 21 /98）,which were found in codons 12,13 and 61. And mutation rate was higher in adenocarcinoma than in adeo-squmaous cacinoma,squmaous cell cacinoma and large cell cacinoma. No correlation was found between K-ras mutations and the gender,the differentiation and smoking staus. Conclusion： The detection rate of EGFR mutation is higher in Chinese. The detection rate of K-ras mutation is lower in Chinese. The mutation in EGFR and K-ras does not present at the same time. The mutation in EGFR of the non-small cell lung cancer is related to gender,histology type and differentiation. The mutation in K-ras is related to histology type.

关 键 词：非小细胞肺癌 EGFR K-RAS 基因突变 

分 类 号：R734.2[医药卫生—肿瘤]