针吸活检与基因突变检测诊断非小细胞肺癌的临床价值  

The clinic value of histology and genetic mutation detection in diagnosis and treatment of non-small-cell lung cancer by transbronchial needle aspiration

作　　者：陈菁[1] 罗光伟[1] 曹艳[1] 聂红[1] 

机构地区：[1]武汉市第一医院呼吸内科,湖北武汉430022

出　　处：《解剖科学进展》2017年第4期405-407,410,共4页Progress of Anatomical Sciences

基　　金：武汉市卫计委资助项目(WX14B03)

摘　　要：目的探讨经支气管镜针吸活检(Transbronchial needle aspiration,TBNA)组织学和基因突变检测在非小细胞肺癌的分型诊断及治疗中的价值。方法探讨经支气管镜针吸活检组织学和基因突变检测在非小细胞肺癌的分型诊断及治疗中的价值。结果进行TTF-1、p63、ck7、ck5/6特异性标记物免疫组化检测的28例TBNA样本的检测结果为:鳞癌15例,腺癌13例。其中10例腺癌进行了EGFR/KRAS/ALK的基因突变检测,检出EGFR突变阳性2例,KRAS阳性1例,未检测到ALK突变。结论通过TTF-1、p63、ck7、ck5/6特异性标记物联合基因突变检测可以较准确区分出鳞癌和腺癌,为临床用药提供指导。Objective To study the clinic value of histology and genetic mutation detection in diagnosis and treatment of non-small-cell lung cancer by transbronchial needle aspiration（TBNA）. Methods Traditional TBNA and Wang＇s tissue-type needle were used to collect central airway lesions（trachea, left and fight main bronchus, pulmonary hilar and mediastinal lymph nodes） from 75 patients in Wuhan First Hospital. All specimens were cytologically and histologically detected, of which 28 cases of non-small cell lung cancer and poorly differentiated carcinoma were immunohistochemieally stainned, and 10 cases of adenocarcinoma samples were further chosen to undergo gene mutation detection. Results 28 cases of TBNA samples specifically marked with TTF-1, p63, ck7 and ck5/6, 15 cases of squamous cell were diagnosed to be carcinoma, 13 cases were diagnosed to be adenocarcinoma. 10 cases of adenocareinoma to be detected as EGFR/KRAS/ALK gene mutations, 2 cases were EGFR mutations positively, 1 case was KRAS positive, but ALK mutation was negative. Conclusion Squamous cell carcinoma and adenocarcinoma could be accurately diagnozed by specifieal markers of TTF-1, p63, ck7 and ck5/6, and combined with gene mutations.

关 键 词：针吸活检 非小细胞肺癌 基因突变 

分 类 号：R734.2[医药卫生—肿瘤]