EGFR基因在胸腹水细胞中的表达及临床意义  

Expression and Clinical Significance of EGFR Gene in Pleuroperitoneal Fluid Cells of Paraffin Blocks

作　　者：曹留炳 仲爱芳 CAO Liubing;ZHONG Aifang(Changzhou Medical District,904 Hospital of Joint Service Support Force,Jiangsu Changzhou 213003,China)

机构地区：[1]联勤保障部队第九O四医院常州医疗区检验病理科,江苏常州213003

出　　处：《河北医学》2020年第12期2028-2031,共4页Hebei Medicine

基　　金：江苏省卫生厅资助基金项目,(编号:20150252078)。

摘　　要：目的:分析表皮生长因子受体(Epidermal growth factor receptor,EGFR)基因在胸腹水细胞中的表达及临床意义。方法:收集2018年6月至2019年6月本院存档的72例胸腹水细胞蜡块标本,采用免疫组化方法观察蜡块标本染色情况,Real-Time PCR法检测胸腹水细胞中EGFR基因相对表达量,突变扩增阻滞系统法检测胸腹水细胞中EGFR基因突变情况。同时分析恶性病变胸腹水细胞中EGFR基因突变检测结果与组织病理结果对比情况。结果:免疫组化结果显示EGFR基因在良性胸腹水细胞石蜡块标本中呈阴性、弱阳性表达,而癌恶性胸腹水细胞石蜡块标本中呈不同强度阳性表达,恶性病变胸腹水细胞中EGFR基因的相对表达量较良性病变胸腹水细胞中EGFR基因的相对表达量显著高(P<0.05);53例恶性病变胸腹水细胞中EGFR基因突变1例,EGFR基因第19外显子被证实存在缺失突变,突变位点为E746-A750 DEL,而EGFR基因第18,20,21外显子未发现突变和SNP位点;以组织病理结果为金标准,恶性病变胸腹水细胞中EGFR基因突变检测的Kappa值为0.658,检测的准确率为98.08%。结论:EGFR基因在胸腹水细胞中的高表达为恶性胸腹水的预警,EGFR基因第19外显子E746-A750 DEL位点的突变可提高靶向治疗的药物敏感性。Objective:To analyze the expression and clinical significance of epidermal growth factor receptor(Epidermal growth factor receptor,EGFR)gene in pleuroperitoneal fluid cells of paraffin blocks.Methods:A total of 72 pleuroperitoneal fluid cell paraffin blocks specimens which were archived in the hospital from June 2018 to June 2019 were collected.The staining situations of paraffin blocks specimens were observed by immunohistochemistry.The relative expression level of EGFR gene was detected by Real-Time PCR.The mutation of EGFR gene in pleuroperitoneal fluid cells of paraffin blocks was detected by Amplification Refractory Mutation System.The comparison situations between the detection results of EGFR gene mutation in malignant pleuroperitoneal fluid cells of paraffin blocks and the histopathological results were analyzed.Results:Immunohistochemical results showed that the EGFR gene was negative and weakly positive in benign pleuroperitoneal fluid cells of paraffin blocks,while it showed positive expression of different degrees in the malignant pleuroperitoneal fluid cells.The relative expression level of EGFR gene in malignant pleuroperitoneal fluid cells of paraffin blocks was significantly higher than that in benign paraffin blocks(P<0.05).Among the 53 malignant pleuroperitoneal fluid cells paraffin blocks,there was 1 case with EGFR gene mutation.There were deletion mutations at the 19th exon of EGFR gene,and mutation site was E746-A750 DEL.There were no mutation and SNP locus at 18th,20th and 21th exon of EGFR gene.Taking histopathological results as the golden standard,Kappa value and detection accuracy rate of EGFR gene mutation in malignant pleuroperitoneal fluid cells of paraffin blocks were 0.658 and 98.08%,respectively.Conclusion:The high expression of EGFR gene in pleuroperitoneal fluid cells of paraffin blocks is an early warning of malignant pleuroperitoneal fluid.Mutation at E746-A750 DEL of EGFR gene 19th exon can improve the drug sensitivity of targeted therapy.

关 键 词：胸腹水细胞 蜡块 表皮生长因子受体基因 临床意义 

分 类 号：R730.6[医药卫生—肿瘤]