超声引导粗针活检在非小细胞肺癌EGFR基因突变检测中的应用  

Application of ultrasound-guided needle biopsy in non-small cell lung cancer EGFR gene mutation detection

作　　者：姜倩[1] 何英[1] 冯峰[2] 朱兴华[3] 陈伟伟[1] Jiang qian;He ying;Feng feng;Zhu xinghua;Chen weiwei(Department of ultrasonography&imaging&pathology,Nantong tumor hospital,Nantong,Jiangsu,226361,China)

机构地区：[1]南通市肿瘤医院超声科,江苏南通226361 [2]南通市肿瘤医院影像科,江苏南通226361 [3]南通市肿瘤医院病理科,江苏南通226361

出　　处：《齐齐哈尔医学院学报》2021年第18期1570-1574,共5页Journal of Qiqihar Medical University

基　　金：江苏省自然科学基金面上项目(BK20161291)。

摘　　要：目的探讨超声引导粗针活检在周围型非小细胞肺癌表皮生长因子受体(EGFR)基因突变检测中的临床应用价值及基因突变状态与临床病理特征的相关性。方法收集2013年10月—2020年10月于本院行超声引导下肺穿刺活检术检测EGFR基因突变的109例周围型非小细胞肺癌患者的临床资料,所有患者均进行了超声引导下粗针活检术,活检标本行病理学检查及ARMS法EGFR基因突变检测。比较患者的年龄、吸烟史、性别、病理类型与临床分期等因素与EGFR基因突变率的相关性。结果51例存在EGFR基因突变,突变率为46.8%;其中以第19外显子缺失(43.1%)和第21外显子L858R突变(39.8%)多见。EGFR基因女性患者突变率显著超过男性患者(60.0%,27.1%,P<0.01);非吸烟患者突变率显著超过吸烟患者(62.1%,29.4%,P<0.01);年龄及分期与基因突变间差异无统计学意义;腺癌EGFR基因突变率(60.8%,P<0.01)显著超过鳞癌及其它肺癌。结论超声引导下对周围型非小细胞肺癌患者行肿块粗针活检能够实现对EGFR基因突变的有效检测,为临床应用靶向药物筛选优势人群。Objective To investigate the clinical application value of ultrasound-guided needle biopsy in the detection of epidermal growth factor(EGFR)gene mutation in peripheral non-small cell lung cancer,and the correlation between gene mutation status and clinicopathological features.Methods The clinical data of 109 patients with peripheral non-small cell lung cancer those underwent ultrasound-guided needle biopsy to detect EGFR gene mutation in our hospital from October 2013 to October 2020 were collected.All the patients received ultrasound-guided needle biopsy,pathological examination was used to detect biopsy specimens and EGFR gene mutation was detected by ARMS.The correlation between the age,smoking history,gender,pathological type and clinical stage of the patients and the mutation rate of EGFR gene was analyzed.Results There were 51 cases of EGFR gene mutation,the mutation rate was 46.8%;among them,the 19th exon deletion(43.1%)and the 21st exon L858R mutation(39.8%)were more common.The mutation rate of EGFR gene in female patients was significantly higher than that of male patients(60.0%,27.1%,P<0.01).The mutation rate of non-smoking patients was significantly higher than that of smokers(62.1%,29.4%,P<0.01).Age and stage werenot correlated with gene mutation.The EGFR gene mutation rate of adenocarcinoma was significantly exceeded to that of squamous cell carcinoma and other lung cancers(60.8%,P<0.01).Conclusions Ultrasound-guided biopsy of non-small cell lung cancer patients could effectively detect EGFR gene mutations,and it could be used as a clinical application for targeted drug scanning.

关 键 词：超声引导 粗针活检 肺癌 基因突变 表皮生长因子受体 

分 类 号：R445.1[医药卫生—影像医学与核医学]