非小细胞肺癌EGFR基因突变的表现及其与肿瘤标记物的相关性  

Expression of EGFR gene mutation in non-small cell lung cancer and its correlation with tumor markers

作　　者：王娜[1] 郑清[2] 孙成铭[2] 刘杰[2] 张贵丽[2] 刘雪娜[1] 刘日明[2] 栾材富[2] 

机构地区：[1]青岛大学,山东青岛266000 [2]青岛大学医学院附属烟台毓璜顶医院,山东烟台264000

出　　处：《现代肿瘤医学》2016年第19期3053-3056,共4页Journal of Modern Oncology

基　　金：烟台市科技发展计划(编号:2013WS228)

摘　　要：目的:探讨非小细胞肺癌(NSCLC)EGFR基因突变位点状态,分析其与血清肿瘤标记物NSE、CEA、CYFRA21-1、TSGF间的关系。方法:回顾性分析240例NSCLC患者组织标本中EGFR不同位点基因突变状态,分析基因突变率与患者性别、年龄、吸烟史和组织分型间的关系及NSCLC患者19、21突变位点与肿瘤标记物NSE、CEA、CYFRA21-1、TSGF的相关性。结果:240例标本突变135例,18号外显子突变2例(1.5%);19号外显子突变47例(34.8%);20号外显子突变7例(5.2%);21号外显子突变71例(52.6%);双突变8例(5.9%)。EGFR突变主要发生在19、21号外显子上,其中19号外显子突变与组织分型有关(P<0.05),与年龄、性别、吸烟史无关(P>0.05);21号外显子突变与组织分型、吸烟史、性别有关(P<0.05),与年龄无关(P>0.05)。EGFR突变组肿瘤标志物NSE、CEA、CYFRA21-1、TSGF的表达水平与未突变组之间差异无统计学意义(P>0.05),19、21号外显子突变的肿瘤标记物NSE、CEA、CYFRA21-1、TSGF之间的差异也无统计学意义(P>0.05)。结论:NSCLC的EGFR突变中19、21号外显子突变率显著高于其他类型,这对于指导临床合理应用EGFR-TKIs药物治疗有重要的意义。而肿瘤标记物NSE、CEA、CYFRA21-1、TSGF在突变组与未突变组之间、19和21号外显子突变之间的差异均无统计学意义。因此,血清肿瘤标记物可能不足以作为评估EGFR突变的指标。Objective：To investigate the status of EGFR gene mutation in NSCLC,and analyze the relationship be-tween CYFRA21 -1,CEA,TSGF and NSE.Methods：To retrospectively analyze data of 240 cases of EGFR samples with different mutation status from NSCLC,and analyse the relationship between gene mutation and gender,age,smok-ing history and tissue typing,also the correlation between 19 and 21 mutation and serum tumor markers NSE,CEA, CYFRA21 -1,TSGF in NSCLC.Results：There were 135 cases of mutation in 240 specimens,the mutations in exons 18 account 2 cases（1.5%）,the mutations in exons 19 account 47 cases（34.8%）,the mutations in exons 20 account 7 cases（5.2%）,the mutations in exons 21 account 71 cases（52.6%）,the mutations in exons double mutant 8 cases （5.9%）.EGFR mutations mainly occurred in exon 19 and 21,the exon 19 mutation was related to organization types （P〈0.05）,but not to age,gender,smoking history（P〉0.05）.The exon 21 mutation was related to organization types,smoking history,gender（P〈0.05）,but not to age（P〉0.05）.The different expression levels of tumor markers NSE,CEA,CYFRA21 -1,TSGF in between EGFR mutation group and non mutation group or between exon 19 muta-tion group and exon 21 mutation group was not statistically significant（P〉0.05）.Conclusion：The mutation rate of exon 19,21 in NSCLC was significantly higher than other types of mutation,can guide the clinical rational use of EG-FR TKIs.The expression level of tumor markers NSE,CEA,CYFRA21 -1,TSGF in EGFR mutation group and non mutation group,exon 19 mutation group and exon 21 mutation group were not statistically significant（P〉0.05）.Ser-um tumor markers may not be sufficient for the assessment of EGFR mutation index.

关 键 词：非小细胞型肺癌 EGFR 基因突变 靶向治疗 肿瘤标记物 

分 类 号：R734.2[医药卫生—肿瘤]