胶质瘤EGFR、EGFRvⅢ蛋白的表达及临床意义  

Expression and Clinical Significance of EGFR and EGFRvⅢProtein in Gliomas

作　　者：朱文标[1] 卢善明 李海南 肖焕钦 罗文娟 谢寿城[1] 刘晋发 ZHU Wenbiao;LU Shanming;LI Hainan;XIAO Huanqin;LUO Wenjuan;XIE Shoucheng;LIU Jinfa(Meizhou People’s Hospital,Meizhou 514031,China;不详)

机构地区：[1]广东省梅州市人民医院,广东梅州514031 [2]广东三九脑科医院

出　　处：《中国医学创新》2020年第10期11-15,共5页Medical Innovation of China

基　　金：梅州市科技计划项目(2017B015)。

摘　　要：目的:探讨EGFR、EGFRvⅢ蛋白在胶质瘤中的表达及其与临床病理的相关性,研究其与胶质瘤患者预后的相关性,分析胶质瘤患者的生存影响因素。方法:选取2013年8月-2018年10月在本院经手术治疗的胶质瘤病例104例,其中低级别胶质瘤(WHOⅡ级)27例,间变性胶质瘤(WHOⅢ级)20例,胶质母细胞瘤(WHOⅣ级)57例。存档蜡块免疫组化检测EGFR、EGFRvⅢ蛋白表达,收集临床病理参数、分子标记物,并进行随访。结果:EGFR蛋白表达阳性率为低级别胶质瘤(WHOⅡ级)44.4%(12/27),间变性胶质瘤(WHOⅢ级)50.0%(10/20),胶质母细胞瘤(WHOⅣ级)68.4%(39/57),随着组织学级别的增加,EGFR阳性率增加,但差异无统计学意义(P>0.05)。EGFRvⅢ蛋白表达阳性率为低级别胶质瘤(WHOⅡ级)0,间变性胶质瘤(WHOⅢ级)为10.00%(2/20),胶质母细胞瘤(WHOⅣ级)为10.53%(6/57),差异无统计学意义(P>0.05)。13.1%(8/61)EGFR阳性胶质瘤表达EGFRvⅢ,EGFR阴性胶质瘤未发现有EGFRvⅢ的表达,两者呈正相关(r=0.242,P<0.05)。EGFR表达与分子标记物1p/19q杂合性缺失有关(P=0.029),与其他临床病理参数及其他分子标记物无关。EGFRvⅢ表达与临床病理参数及分子标记物无关。单因素分析显示EGFRvⅢ、年龄、组织学级别、KPS评分、治疗方案、IDH1基因突变、ATRX基因突变与胶质瘤患者生存有关(P<0.05),Cox分析显示年龄、组织学级别、治疗方案及分子标记物IDH1是胶质瘤患者独立的预后预测因素(P<0.05),EGFRvⅢ不是胶质瘤患者独立的预后因素(P>0.05)。结论:胶质瘤EGFR、EGFRvⅢ蛋白的表达具有一定的临床意义,但不能作为胶质瘤的独立预后因素。Objective:To investigate the expression and clinical significance of EGFR and EGFRvⅢprotein in gliomas.Method:A total of 104 cases of gliomas were treated in our hospital from August 2013 to October 2018,including 27 cases of low-grade gliomas(WHO gradeⅡ),20 cases of anaplastic gliomas(WHO gradeⅢ)and 57 cases of glioblastoma(WHO gradeⅣ).EGFR and EGFRvⅢprotein expression were detected by immunohistochemistry.The clinical pathological parameters and molecular markers were collected and all the cases were followed up.Result:The positive rate of EGFR protein expression was 44.4%(12/27)in low-grade gliomas,50.0%(10/20)in anaplastic gliomas and 68.4%(39/57)in glioblastomas.With the increase of WHO grade,the EGFR positive rate increased,but the difference was not significant(P>0.05).The positive rate of EGFRvⅢprotein expression was 0 in low grade gliomas,10.0%(2/20)in anaplastic gliomas and 10.53%(6/57)in glioblastomas.The difference was not significant(P>0.05).13.1%(8/61)EGFR-positive gliomas expressed EGFRvⅢ,and all EGFR-negative gliomas did not show EGFRvⅢexpression.The express of EGFR and EGFRvⅢwas positive correlation(r=0.242,P<0.05).EGFR expression was associated with co-deletion of 1q/19p(P=0.029),while was not associated with clinicopathological parameters and other molecular markers.EGFRvⅢexpression was not associated with clinicopathological parameters and molecular markers.Univariate analysis showed EGFRvⅢ,age,WHO grade,KPS score,treatment regimen,IDH1 mutation and ATRX gene mutation were associated with survival of glioma patients(P<0.05),Cox analysis showed age,WHO grade,treatment regimen and IDH1 mutation were independent prognostic predictors of glioma patients(P<0.05),and EGFRvⅢwas not independent prognostic factor for glioma patients(P>0.05).Conclusion:The expression of EGFR and EGFRvⅢprotein has certain clinical significance,but it was not independent prognostic factor for gliomas.

关 键 词：胶质瘤 EGFR EGFRvⅢ 

分 类 号：R739.41[医药卫生—肿瘤]