405例肺癌合并肺结核患者临床特征及驱动基因检测分析  

Analysis of Clinical Characteristics and Driver Genes in 405 Patients with Lung Cancer Complicated with Tuberculosis

作　　者：胡瑛[1] 杨新杰[1] 聂理会[2] 赵丹[3] 安军[4] 李宝兰[1] Ying HU;Xinjie YANG;Lihui NIE;Dan ZHAO;Jun AN;Baolan LI(Department of Oncology,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;Department of Tuberculosis,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;Department of Pathology,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;Department of Medical Records,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院肿瘤内科,北京101149 [2]首都医科大学附属北京胸科医院结核内科,北京101149 [3]首都医科大学附属北京胸科医院病理科,北京101149 [4]首都医科大学附属北京胸科医院病案科,北京101149

出　　处：《中国肺癌杂志》2020年第5期337-342,共6页Chinese Journal of Lung Cancer

摘　　要：背景与目的随着肺癌研究进展,靶向治疗、免疫检查点抑制剂等新的治疗方法已经开始应用于肺癌患者,因此需要进一步了解合并肺结核的肺癌患者的临床及实验室特点,从而为此类患者的临床治疗提供新的思路。本研究目的是分析肺癌合并肺结核患者的临床特征、驱动基因检测结果及其之间关系。方法回顾性分析我院2014年1月-2019年12月收治的405例肺癌合并肺结核患者,应用统计学方法分析其临床特征与驱动基因状态之间的关系。结果405例肺癌合并肺结核患者中男性占77.3%,有吸烟史患者占85.3%,病理类型以肺腺癌为主,当胸部影像学有空洞改变时以鳞癌为主要类型。214例患者进行驱动基因检测,表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变率为35.9%,其中41.8%为外显子19缺失突变,50.9%为外显子21 L858R突变。当胸部影像有空洞改变时,EGFR突变率显著降低(16.1%)。间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)融合基因检测阳性率为2.5%,原癌基因1酪氨酸激酶(c-ros oncogene 1 receptorkinase,ROS1)突变率为1.9%,肉瘤病毒致癌基因同源物B1(V-raf murine sarcoma viral oncogene homolog B1,BRAF)基因突变率为1.1%,克尔斯滕大鼠肉瘤病毒致癌基因同源物(Kirsten Rat Sarcoma Viral Oncogene Homolog,KRAS)基因突变率为10.1%。女性肺癌合并肺结核患者基因突变率为50.0%,男性为27.9%。结论肺癌合并肺结核患者以有吸烟史的男性患者为主,病理类型以腺癌为主。基因突变阳性率与单纯肺癌无明显差异,但是当胸部影像有空洞表现时,基因突变率显著降低。Background and objective New treatment methods such as targeted therapy and immune checkpoint inhibitors have been applied to lung cancer patients.It is necessary to further understand the patients with lung cancer combined with pulmonary tuberculosis with the development of lung cancer research.The purpose of this study was to analyze the clinical characteristics of lung cancer patients with pulmonary tuberculosis,the status of driver genes,and their relationships.Methods A retrospective analysis was performed on 405 patients with lung cancer and pulmonary tuberculosis hospitalized in our hospital from January 2014 to December 2019.The relationship between clinical characteristics and driver genes status was analyzed.Results Among the 405 patients with lung cancer combined with pulmonary tuberculosis,77.3%were male and 85.3%were patients with a history of smoking.The pathological type was mainly lung adenocarcinoma.When there were cavities in chest computed tomography(CT),squamous cell carcinoma was the main type.214 patients underwent driver genes testing.The epidermal growth factor receptor(EGFR)gene mutation rate was 35.9%,of which 41.8%were exon 19 deletion mutations and 50.9%were exon 21 L858 R mutations.When there were cavities in the chest CT,the EGFR mutation rate was significantly reduced(16.1%).The positive rate of anaplastic lymphoma kinase(ALK)fusion gene detection was 2.5%,the mutation rate of c-ros oncogene 1 receptor kinase(ROS1)gene was 1.9%,the mutation rate of V-raf murine sarcoma viral oncogene homolog B1(BRAF)gene was 1.1%,and the mutation rate of Kirsten Rat Sarcoma Viral Oncogene Homolog(KRAS)gene was 10.1%.The genetic mutation rate of female patients with lung cancer and pulmonary tuberculosis was 50.0%,and thatof men was 27.9%.Conclusion Patients with lung cancer and pulmonary tuberculosis are predominantly male with smoking history.Adenocarcinoma is the most common pathological type.The positive rate of gene mutation was not significantly different from that of simple lung cancer,but whe

关 键 词：肺肿瘤 肺结核 驱动基因 

分 类 号：R734.2[医药卫生—肿瘤] R521[医药卫生—临床医学]