EGFR在肺泡上皮不典型腺瘤样增生中表达和突变的意义研究  

Study on the Significance of the Expression and Mutation of EGFR in Atypical Adenomatous Hyperplasia

作　　者：黄谦[1] HUANG Qian(Department of Basic Medicine,Yueyang Vocational Technical College,Yueyang,Hunan 414000)

机构地区：[1]岳阳职业技术学院医学基础部,湖南岳阳414000

出　　处：《岳阳职业技术学院学报》2020年第5期83-87,共5页Journal of Yueyang Vocational and Technical College

基　　金：湖南省教育厅高校一般科研项目“EGFR在肺泡上皮非典型增生中的表达和突变研究”(14C1151)。

摘　　要：目的探讨表皮生长因子受体(epidermal growth factor receptor,EGFR)在肺泡上皮不典型腺瘤样增生(atypical adenomatous hyperplasia,AAH)中的表达和突变及其临床意义,为提高细支气管肺泡癌(bronchioloalveolar lung carcinoma,BAC)的早期诊断和治疗水平提供理论依据,同时也为进一步研究肺癌的发病机制奠定基础。方法收集2006年1月-2010年6月经病理确诊有肺泡上皮不典型增生的病例,随机抽取41例组织学表现程度不同的肺泡上皮AAH病例(包括23例单纯AAH病变病例和18例癌旁肺泡上皮不典型增生病例)的石蜡包埋组织块,收集其临床病理资料。用免疫组织化学技术S-P法检测肺泡上皮AAH组织中EGFR蛋白的表达及EGFR19和EGFR21外显子基因突变蛋白的表达情况。对所有病例资料及实验结果应用SPSS18统计软件进行数据分析。结果41例病例中17例高度AAH的病例EGFR蛋白全部表达为阳性,24例低度AAH病例中只有17例EGFR蛋白表达阳性,二者有显著性差异(P<0.05);17例高度AAH病例中有13例出现第19号外显子突变,24例低度AAH病例中只有1例第19号外显子突变,二者有显著性差异(P<0.05);7例高度AAH病例中有7例第21号外显子突变,24例低度AAH病例中有2例第21号外显子突变,二者有显著性差异(P<0.05);EGFR第19、21号外显子突变与EGFR蛋白阳性表达呈正相关;EGFR蛋白阳性表达及其第19、21号外显子突变均与AAH患者性别、年龄无关;41例癌旁肺泡上皮不典型增生患者与单纯AAH病变患者在EGFR蛋白表达、EGFR基因第19号外显子突变蛋白表达及EGFR基因第21号外显子突变蛋白表达均有显著性差异(P值均<0.05)。结论EGFR蛋白的过表达及其第19、21号外显子突变与AAH的发生、发展密切相关,且EGFR基因第19、21号外显子突变可能导致EGFR蛋白的高表达;癌旁肺泡上皮不典型增生患者EGFR蛋白的阳性表达率及其第19、21号外显子突变率均高于单纯AAH病变患者。Objective:To investigate the expression and mutation of epidermal growth factor receptor(EGFR)in the alveolar epithelial atypical adenomatoid hyperplasia(AAH)and its clinical significance,will provide a theoretical basis for improving the early diagnosis and treatment of bronchioloalveolar lung carcinoma(BAC),and for the further meachnism study of the pathogenesis of lung cancer.Methods:The cases of AAH were collected from January 2006 to June 2010,and 41 cases were sampling randomly including 23 cases of simple AAH lesions and 18 cases of paracancer alveolar epithelial atypical hyperplasia.Immunohistochemistry was applied to detect the protein expression of EGFR and exons 19 and 21 of EGFR in alveolar epithelial AAH tissue.All the cases and experimental results were analyzed by SPSS18 data analysis,.Results:In 41 cases,EGFR protein was detected in17 high-grade AAH cases,and it also could be detected in 17 of 24 low-grade AAH cases(P<0.05);In 17 highgrade AAH cases,mutation of exon 19 was detected in 13 cases.But in 24 low-grade AAH cases,only 1 case could detect mutation of exon 19(P<0.05);Mutation of exons 21 was detected in 7 of 17 high-grade AAH cases and in 2 of 21 low-grade AAH cases(P<0.05);There’s a positive correlation between mutation of exon 19 and 21 of EGFR and its protein expression;EGFR protein expression and mutation of exons 19 and 21 were not associated with sex or ages of the AAH patients;In 41 cases of AAH,EGFR protein expression and mutation of exons 19 and 21 in the adjacent alveolar epithelial atypical hyperplasia cases were significant difference with in the simple AAH cases(P<0.05).Conclusion:Over expression of EGFR protein and mutations of exons 19 and 21 are closely related to the development of AAH,and the high expression of EGFR protein may be leaded to the mutation of exon 19 or 21;The adjacent alveolar epithelial atypical hyperplasia cases has a higher rate of EGFR protein expression and a higher rate of mutation of exon 19 and 21 than the simple AAH cases.

关 键 词：肺癌 细支气管肺泡癌 肺泡上皮不典型腺瘤样增生 表皮生长因子受体 突变 

分 类 号：R446.62[医药卫生—诊断学]