非小细胞肺癌患者不同类型样本中表皮生长因子受体基因突变的差异研究  

Detection of Epidermal Growth Factor Receptor Gene Mutation in Different Sample Types of 238 Patients with Non-small Cell Lung Cancer

作　　者：喻晶[1] 李运雷 刘晓翌[1] YU Jing;LI Yun-lei;LIU Xiao-yi(Department of Laboratory Medicine,Beijing University Shenzhen Hospital,Guangdong Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院检验科,广东深圳518036

出　　处：《现代检验医学杂志》2018年第4期31-33,共3页Journal of Modern Laboratory Medicine

摘　　要：目的检测238例非小细胞肺癌(NSCLC)患者不同类型样本中表皮生长因子受体(EGFR)基因的突变情况,探讨不同类型样本在EGFR基因突变中的应用价值。方法采用扩增阻碍突变系统(ARMS)检测238例NSCLC中EGFR基因18~21外显子的突变情况,探讨不同样本类型、不同性别、不同年龄、不同病理分型和不同临床分期的EGFR突变频率的差异及临床意义。结果 238例NSCLC患者EGFR总的突变率为44.5%(106/238),其中组织、血浆和胸腔积液样本分别为105例,115例和18例,其突变率分别为52.4%(55/105),34.8%(40/115)和61.1%(11/18),与组织样本相比,血浆样本的EGFR突变检出率明显低于组织样本,差异具有统计学意义(χ~2=6.93,P<0.05),但组织与胸腔积液样本相比其检出率差异无统计学意义(χ~2=0.471,P>0.05)。女性NSCLC患者的EGFR突变的检出率明显高于男性患者,差异有统计学意义(55.3%vs 36.3%,χ~2=8.58,P<0.01)。>65岁患者与≤65岁患者的突变检出率差异无统计学意义(44.4%vs 44.6%,χ~2=0,P>0.05)。肺腺癌的EGFR突变检出率明显高于其他类型的NSCLC,差异有统计学意义(47.7%vs29.3%,χ~2=4.68,P<0.05)。临床Ⅰ~Ⅱ期患者的EGFR突变检出率与Ⅲ~Ⅳ期的相比差异无统计学意义(35.0%vs45.7%,χ~2=0.79,P>0.05)。结论组织样本EGFR基因突变的检出率与胸腔积液样本相比无统计学差异,但明显高于血浆样本,提示临床选择送检的样本类型时,可优先选择组织和胸腔积液样本。EGFR基因突变的检出率与性别和肿瘤的病理类型相关。Objective To detect the epidermal growth factor receptor（EGFR）mutation in different types of samples of 238 patients with non-small cell lung cancer（NSCLC）,and explore the clinical application value of the EGFR gene mutation in different types of samples.Methods Mutations in the exons 18-21 of EGFR gene in 238 patients with non-small cell lung cancer were detected by amplification refractory mutation system（ARMS）,to investigate the frequency and clinical significance of EGFR mutation in different sample types,genders,ages,pathological types,and clinical stages.Results The total mutation rate of EGFR was 44.5%（106/238）in 238 patients with NSCLC.The number of tissue,plasma and pleural effusion samples were 105,115 and 18,and the mutation rate was 52.4%（55/105）,34.8%（40/115）,61.1%（11/18）respectively.Compared with tissue sample,the mutation rate of plasma samples was significantly lower than that of tissue samples,the difference was statistically significant（χ2=6.93,P〈0.05）,but there was no statistical difference of mutation rate in pleural effusion samples compared with tissue samples（χ2=0.471,P〉0.05）.The EGFR mutations rate in female NSCLC patients was dramatically higher than that of male patients（55.3% vs 36.3%,χ2=8.58,P〈0.01）.No statistical difference of the mutation rate was found between patients〉65 years old and ≤65 years old（44.4% vs 44.6%,χ2=0,P〈0.05）.The EGFR mutation rate in patients with lung adenocarcinoma was significantly higher than that of patients with other types of NSCLC（47.7% vs 29.3%,χ2=4.68,P〈0.05）.There was no statistical difference in the EGFR mutation rate between patients in clinical stage Ⅰ-Ⅱ and in stage Ⅲ-Ⅳ（35.0% vs 45.7%,χ2=0.79,P〉0.05）.Conclusion The EGFR mutations rate in tissue samples had no significant difference from that of pleural effusion samples,but it was significantly higher than that of plasma samples.This suggests that tissue and pleural effusion samples could be the first choice for the cli

关 键 词：表皮生长因子受体(EGFR)基因突变 不同类型样本 非小细胞肺癌 扩增阻碍突变系统(ARMS) 

分 类 号：R734.2[医药卫生—肿瘤] R730.43[医药卫生—临床医学]