肺癌原发灶与纵隔转移性淋巴结病理学特征及EGFR表达相关性分析  

Analysis on correlation between primary lesion of lung cancer with pathological characteristics of mediastinal metastatic lymph nodes and EGFR expression

作　　者：王林辉[1] 吕莎莎 陈慧勇[3] 杜日昌[1] 李银珍 WANG Linhui;LV Shasha;CHEN Huiyong;DU Richang;LI Yinzhen(Department of Pathology,Yuebei People′s Hospital,Shaoguan,Guangdong 512026,China;Department of Pathology,Xinjiang Production Construction Corps Thirteen Divison Red Star Hospital,Hami,Xinjiang 839000,China;Department of Thoracic Surgery,Yuebei People′s Hospital,Shaoguan,Guangdong 512026,China)

机构地区：[1]韶关市粤北人民医院病理科,广东韶关512026 [2]哈密第十三师红星医院病理科,新疆哈密839000 [3]韶关市粤北人民医院胸外科,广东韶关512026

出　　处：《现代医药卫生》2020年第15期2322-2325,共4页Journal of Modern Medicine & Health

基　　金：广东省韶关市卫生健康委员会科研课题项目(Y19037)。

摘　　要：目的分析非小细胞肺癌(NSCLC)患者原发灶及纵隔转移性淋巴结病理特征及表皮生长因子受体(EGFR)突变在肺癌原发灶与纵隔转移性淋巴结的表达情况,分析临床病理特征的相关性及EGFR基因突变情况,探讨肺癌原发灶与纵隔转移性淋巴结病理特征是否存在区别,与EGFR表达是否具有一致性。方法采用突变扩增系统-聚合酶链反应法,对2016年1月至2018年6月广东省韶关市粤北人民医院收治的经手术治疗的ⅡA~ⅢB期NSCLC患者132例样本中原发灶及纵隔转移性淋巴结的病理特征进行分析,并对EGFR基因进行检测。结果132例NSCLC患者中腺癌87例,腺鳞癌10例,淋巴上皮瘤样癌2例,鳞癌33例;腺癌、鳞癌患者中纵隔转移性淋巴结病理特征与原发灶一致,但在腺鳞癌患者中纵隔转移性淋巴结为腺癌7例,腺鳞癌2例,鳞癌1例,淋巴结与原发灶的病理特征具体高度一致性[93.2%(123/132)],但腺鳞癌患者纵隔转移性淋巴结转移以腺癌居多。纵隔淋巴结转移与肿瘤分化程度具有相关性。肺原发灶EGFR突变率为32.6%(43/132),纵隔转移性淋巴结EGFR突变率为29.5%(39/132),且EGFR突变表达多见于女性、不吸烟人群、有腺癌成分者,其表达与吸烟、病理类型具有明显相关性;与肿瘤分化程度、患者年龄无关;吸烟、病理类型是EGFR突变的2个独立影响因素,不吸烟的NSCLC患者具有更高的EGFR突变率。结论NSCLC患者原发灶与纵隔转移性淋巴结病理学特征具有较高的一致性,腺鳞癌患者纵隔淋巴结转移与占主要成分的组织类型相关;腺癌患者原发灶与纵隔转移性淋巴结的EGFR表达具有较高的一致性,腺鳞癌患者原发灶与纵隔转移性淋巴结EGFR表达存在差异。Objective To analyze the pathological characteristics of primary lesion and mediastinal metastatic lymph nodes in the patients with non-small cell lung cancer(NSCLC)and the expression of EGFR mutation in primary lesion of lung cancer and metastatic lymph nodes,to analyze the correlation of clinicopathological features and mutations of EGFR gene,to explore whether the difference existing in the pathological features of lung cancer primary lesion and mediastinal metastatic lymph nodes,and whether the expression of EGFR having consistency.Methods ARMS-PCR was adopted to analyze the pathological characteristics of primary lesion and metastatic lymph nodes in 132 cases of stageⅡA-ⅢB NSCLC treated by operation in the Yuebei People′s Hospital from January 2016 to June 2018.The EGFR gene was detected.Results In 132 cases of NSCLC,87 cases were adenocarcinoma,10 cases were adenosquamous carcinoma,2 cases were lymphoepitheliomatous carcinoma,33 cases were squamous carcinoma,the pathological characteristics of mediastinal metastatic lymph nodes were the same as the primary lesion,but in the patients with adenosquamous carcinoma,the mediastinal metastatic lymph nodes were adenocacinoma in 7 cases,2 cases were adenosquamous carcinoma and 1 case was squamous carcinoma.The lymph nodes were highly consistent with the pathological characteristics of e primary lesion[93.2%(123/132)].However the mediastinal metastasis lymph nodes in the patients with adenosquamous carcinoma were mainly adenocarcinoma.The mediastinal lymph node metastasis had a correlation with the tumor differentiation degree.The EGFR mutation rate in the lung primary lesion was 32.6%(43/132),which in the mediastinal metastasis lymph node was 29.5%(39/132),moreover the EGFR mutation expression was common in females,nonsmokers and patients with adenocarcinoma.The expression of EGFR was significantly correlated with smoking and pathological types.There was no significant correlation between EGFR gene mutation rate and tumor differentiation degree,patient age an

关 键 词：癌 非小细胞肺 淋巴结 肿瘤转移 受体 表皮生长因子 基因 突变 病理特征 

分 类 号：R734.2[医药卫生—肿瘤] R73-37[医药卫生—临床医学]