超声引导粗针活检在非小细胞肺癌诊断及EGFR基因突变检测中的应用  

Ultrasound-guided core-needle biopsy in non-small cell lung cancer diagnosis and EGFR mutation detection

作　　者：何英[1] 张晴[1] 姜倩[1] 朱兴华[2] 郭燕[2] 李剑英[3] 

机构地区：[1]南通市肿瘤医院超声科,江苏南通226361 [2]南通市肿瘤医院病理科,江苏南通226361 [3]南通市肿瘤医院内科,江苏南通226361

出　　处：《现代肿瘤医学》2017年第21期3439-3441,共3页Journal of Modern Oncology

基　　金：南通市社会发展项目(编号:HS13908)

摘　　要：目的:探讨超声引导下粗针活检在周围型非小细胞肺癌的诊断及EGFR基因突变检测中应用价值。方法:31例周围型非小细胞肺癌患者行超声引导下肺肿块粗针活检术,活检小标本行病理学检测及PCR法EGFR基因突变分析。结果:31例非小细胞肺癌活检小标本取材满意率100%,穿刺定性诊断符合率100%,EGFR基因检出率100%,并发症发生率3.2%。病理结果:腺癌25例、鳞癌2例、腺鳞癌3例、肉瘤样癌1例。31例非小细胞肺癌活检小标本中,检测到EGFR基因突变11例,阳性率35.5%。其中5例为第19外显子框内多核苷酸缺失,5例为第21外显子L858R突变,1例为联合突变L861Q/G719X(第18外显子G719X突变和第21外显子L861Q突变)。结论:超声引导下肺肿块粗针活检术简便、安全、有效,能明确周围型非小细胞肺癌的诊断,是非小细胞肺癌获得肿瘤组织检测EGFR基因突变的可靠方法。Objective： To investigate the application value of ultrasound - guided core - needle biopsy in peripher- al non - small cell lung cancer diagnosis and EGFR mutation detection. Methods ：The data of 31 cases of peripheral lung cancer patients underwent ultrasound - guided core - needle biopsy of the pulmonary masses and the specimens went through pathology tests and PCR gene sequencing for EGFR mutation detections. Results：The specimens were satisfactory in all 31 cases, the concordance rate between biopsy results and diagnoses was 100% and so was the de- tection rate for EGFR. The incidence of complications was 3.2%. The pathologic findings were ：25 cases of adenocar- cinoma,2 cases of squamous carcinoma,3 cases of adenosquamous carcinoma and 1 case of sarcomatoid carcinoma. EGFR mutation was detected in 11 cases of the specimens out of the 31 cases, with a positive rate at 35.5 %. Among them,5 were in- frame deletions of nucleotides in exon 19,5 were exon 21 L858R mutations and the last one was L861Q/G719X combined mutation （ exon 18 G719X and exon 21 L861Q mutations）. Conclusion ： Ultrasound - guided core - needle biopsy of pulmonary masses is a convenient, safe and efficacious way of confirming the diagnosis of peripheral non - small cell lung cancer and a reliable way to detect EGFR mutations in tumor tissues.

关 键 词：超声引导 粗针活检 非小细胞肺癌 EGFR 基因突变 

分 类 号：R734.2[医药卫生—肿瘤]