表现为肺结节的早期肺腺癌病理与多种驱动基因关系探讨  

Investigation of the relationship between pathologic stage characteristics of early lung adenocarcinoma manifested with nodule and abnormality of multiple driver genes

作　　者：赵静 李明[2] 李传应 汪世存 操乐杰 ZHAO Jing;LIMing;LI Chuan-ying;WANG Shi-cun;CAO Le-jie(the Affiliated Provincial Hospital of Anhui Medical University,Hefei,Anhui 230001,China)

机构地区：[1]安徽医科大学附属省立医院呼吸内科,安徽合肥230001 [2]安徽医科大学附属省立医院病理科,安徽合肥230001 [3]安徽医科大学附属省立医院PET-CT室,安徽合肥230001

出　　处：《临床肺科杂志》2018年第8期1459-1463,共5页Journal of Clinical Pulmonary Medicine

基　　金：2013安徽省卫生厅医学科研课题计划(No 13zc001);2013安徽省科技攻关计划项目(No 1301042216)

摘　　要：目的探讨表现为肺结节的早期肺腺癌病理分期与驱动基因EGFR、ALK、ROS1、KRAS突变之间的关系。方法调取我院收治的40例手术切除表现为结节的早期肺腺癌与10例良性肺结节患者做对照,采用扩增阻滞突变系统(ARMS)法检测石蜡标本中该四种基因异常情况,分析驱动基因突变及病理分型的关系。结果 40例早期肺腺癌患者中31例检出突变,总突变率77.5%。四基因突变与结节组织分型密切相关(p<0.05)。与原位腺癌及微浸润腺癌相比,浸润性肺腺癌具有更多的基因异常及更高的SUVmax及SUV代谢指数(P<0.05),但四基因突变与SUVmax及SUV代谢指数均无明显相关性。结论早期肺腺癌即出现非常高的驱动基因异常,四基因异常达到77.5%。随着早期肺腺癌分期的发展,四基因异常检出率升高,提示以结节表现的肺腺癌早期发生、发展中,驱动基因异常发挥重要作用。Objective To investigate the relationship between the pathologic stage characteristics of early lung adenocarcinoma manifested with nodule and the driver genes EGFR,EML4-ALK,ROS1 and KRAS mutations.Methods A total of 40 patients with early lung adenocarcinoma manifested with nodule who underwent surgical resection were enrolled and compared with 10 cases of benign pulmonary nodules in the study. The expression of EGFR,EML4-ALK,ROS1 and KRAS of paraffin specimens detected by Amplified Block Mutation System（ ARMS）were analyzed,and the relationship between different imaging features and gene mutation and pathologic type was analyzed. Results A total of 31 cases of mutations were detected in 40 cases of early lung adenocarcinoma with a total mutation rate of 77. 5%. The mutations of four driver genes and EGFR mutation were closely related to histological classification（ P〈0. 05）. Invasive lung adenocarcinoma had higher SUVmax and SUV metabolic index（ P〈0. 05）.However,the mutations of four driver genes and EGFR mutation were not related to SUVmax and SUVmetabolic index. Conclusion Early lung adenocarcinoma shows a very high driver gene abnormalities as four gene abnormalities reached to 77. 5%. The detection rate of four genes abnormalities increases with the development of nodular malignancy,suggesting that early driver genes of nodular lung adenocarcinoma play an important role in the early occurrence and development of lung adenocarcinoma manifested with nodule.

关 键 词：肺结节 肺癌 早期 驱动基因 

分 类 号：R734.2[医药卫生—肿瘤]