晚期非小细胞肺癌EGFR基因突变及其与患者临床特征的相关性  

EGFR gene mutation in advanced non-small cell lung cancer and its correlation with clinical characteristics

作　　者：孙向飞[1] 张晓炜[1] 董济民[1] SUN Xiang-fei;ZHANG Xiao-wei;DONG Ji-min(Department of Oncology,Xi'an Central Hospital Affiliated to the Medicine College of Xi'an Jiaotong University,Xi'an 710003,Shannxi,CHINA)

机构地区：[1]西安交通大学医学院附属西安市中心医院肿瘤科,陕西西安710003

出　　处：《海南医学》2020年第12期1500-1503,共4页Hainan Medical Journal

摘　　要：目的探索晚期非小细胞肺癌(NSCLC)患者中EGFR基因状态与患者临床特征的内在关系。方法回顾性分析西安市中心医院肿瘤科2015年1月至2018年12月收治的72例初诊晚期NSCLC患者的临床资料,统计其EGFR基因突变、性别、吸烟、病理类型、淋巴结转移、首发远处转移灶以及癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(Cy211)等指标,分析EGFR基因突变情况与上述各项指标的相关性。结果 72例初诊晚期NSCLC患者的EGFR基因总体突变率为44.44%。不吸烟患者的EGFR基因突变率为60.00%(21/35),高于吸烟患者的29.73%(11/37),差异有统计学意义(P<0.05);不同病理类型肺癌中的EGFR基因突变率也不同,腺癌中EGFR基因突变率最高,腺鳞癌次之,鳞癌最低,差异有统计学意义(P<0.05);有淋巴结转移的NSCLC患者的EGFR基因突变率为70.83%,明显高于无淋巴结转移的31.25%,差异有统计学意义(P<0.05);EGFR基因突变的NSCLC患者脑部转移发生率高于其他部位,EGFR基因突变与脑转移之间呈中度正相关(r=0.491,P<0.05),而与骨转移呈中度负相关(r=-0.47,P<0.05);CEA及Cy211在EGFR基因突变患者中表达均值分别为(6.75±3.44) ng/mL、(9.82±7.34)μg/L,而在EGFR野生型患者中的CEA及Cy211的表达均值分别为(14.73±14.29) ng/mL、(28.51±24.54)μg/L,CEA及Cy211在EGFR野生型患者中的表达水平更高,两组间比较差异均有统计学意义(P<0.05)。结论晚期NSCLC患者中EGFR基因的突变率整体较高,EGFR基因突变与患者的临床特征相关,腺癌、非吸烟人群、淋巴结转移等临床特征的患者更易携带EGFR基因的突变;EGFR基因突变与脑转移成正相关,但与骨转移成负相关。此外,低表达CEA及Cy211可能与EGFR突变有相关性,可作为预测EGFR基因是否突变的参考指标。Objective To investigate the intrinsic relationship between epithelial growth factor receptor(EGFR)gene status and clinical characteristics in patients with advanced non-small cell lung cancer(NSCLC).Methods The clinical data of 72 newly diagnosed advanced NSCLC patients admitted to the Department of Oncology,Xi'an Central Hospital from January 2015 to December 2018 were analyzed retrospectively.The EGFR gene mutation,gender,smoking,pathological type,lymph node metastasis,first distant metastasis and carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),cytokeratin 19 fragment(Cy211)were observed.Correlation between EGFR gene mutation and the above indexes were analyzed.Results The overall mutation rate of EGFR gene in the 72 newly diagnosed advanced NSCLC patients was 44.44%.The mutation rate of EGFR genes in non-smoking patients was 60.00%(21/35),which was significantly higher than 29.73%(11/37)in smoking patients(P<0.05).Different pathological types of lung cancer had different rates of EGFR gene mutation.The mutation rate of EGFR gene was the highest in adenocarcinoma,followed by adenosquamous carcinoma and then squamous cell carcinoma,with statistically significant difference(P<0.05).The mutation rate of EGFR gene in NSCLC patients with lymph node metastasis was 70.83%,which was significantly higher than 31.25%in patients without lymph node metastasis(P<0.05).The incidence of brain metastasis in NSCLC patients with EGFR gene mutation was higher than that in other parts.There was a moderate positive correlation between EGFR gene mutations and brain metastases(r=0.491,P<0.05),but a moderate negative correlation between EGFR gene mutations bone metastasis(r=-0.47,P<0.05).The mean expression values of CEA and Cy211 in patients with EGFR gene mutation were(6.75±3.44)ng/mL and(9.82±7.34)μg/L,which was significantly lower than(14.73±14.29)ng/mL and(28.51±24.54)μg/L in EGFR wild-type patients(P<0.05).Conclusion EGFR gene mutation rates are higher in patients with advanced NSCLC.EGFR gene mutations are rel

关 键 词：非小细胞肺癌 表皮生长因子受体 癌胚抗原 神经元特异性烯醇化酶 细胞角蛋白19片段 临床特征 相关性 

分 类 号：R734.2[医药卫生—肿瘤]