晚期非小细胞肺癌患者肿瘤组织、血液、胸腔积液EGFR基因突变一致性研究  

Consistency of EGFR Mutation in Tumor Tissue,Blood and Pleural Effusion of Patients with Advanced Non-small Cell Lung Cancer

作　　者：高山 高岩 杨俊省[1] 田涛[1] GAO Shan;GAO Yan;YANG Junsheng;TIAN Tao(Department of Oncology,Zaozhuang Municipal Hospital,Zaozhuang 277100,Shandong,China)

机构地区：[1]枣庄市立医院肿瘤科,山东枣庄277100

出　　处：《中国药物滥用防治杂志》2021年第6期956-959,共4页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：山东省医药卫生科技发展计划项目(项目编号:2018WSA04025)。

摘　　要：目的:检测非小细胞肺癌(NSCLC)患者肿瘤组织、血液及胸腔积液中表皮生长因子受体基因(EGFR)第19和21外显子的突变状态,初步探讨肿瘤组织与血液,胸腔积液EGFR阳性检出率的关系。方法:收集2019年1月—2020年10月确诊为NSCLC患者并行EGFR基因检测的病例269例,另收集同期进行肿瘤组织、血液、胸腔积液EGFR检测的NSCLC患者54例,EGFR-TKI耐药后同时行血液及胸腔积液T790M检测的患者23例,检测患者肿瘤组织、血液及胸腔积液中EGFR第19和21外显子的突变状态,分析EGFR突变与临床病理之间的关系,并分析血液、胸腔积液与配对肿瘤组织标本EGFR检测的一致性。结果:女性突变率为61.11%,高于男性的35.66%;腺癌突变率为49.79%,高于鳞癌的11.11%,差异有统计学意义(P<0.05)。血液、胸腔积液与对应的肿瘤组织相比,对EGFR突变的检出具有较好的一致性,Kappa值分别是0.72、0.84。胸水T790M突变率为65.22%,高于血液T790M突变率的52.17%,但差异无统计学意义(P>0.05)。结论:女性、腺癌的NSCLC患者EGFR突变率高于男性、鳞癌患者;血液、胸腔积液与对应的肿瘤组织相比,对EGFR突变的检出具有较好的一致性,对于失去组织活检的NSCLC患者,仍可以通过血液、胸腔积液检测EGFR突变状态;仍有超半数一代EGFR-TKI耐药患者能从三代EGFR-TKI药物中获益。Objective:To detect the mutation status of exons 19 and 21 of epidermal growth factor receptor gene(EGFR) in tumor tissues,blood and pleural effusion of patients with advanced cell lung cancer,and to preliminarily investigate the relationship between tumor tissues and the positive detection rate of EGFR in blood and pleural effusion,so as to guide the clinical medication of patients with advanced cell lung cancer.Methods:A total of 269 patients with NSCLC who underwent EGFR gene detection from January 2019 to October 2020 were collected.At the same time,54 patients with NSCLC who underwent EGFR detection in tumor tissue,blood and pleural effusion were collected.After EGFR-TKI resistance,23 patients underwent T790 M detection in blood and pleural effusion.The mutation status of EGFR exon 19 and 21 in tumor tissue,blood and pleural effusion was detected,and the relationship between EGFR mutation and clinical pathology was analyzed.The consistency of EGFR detection between blood,pleural effusion and paired tumor tissue samples was analyzed.Results:The the mutation rate of women was 61.11%,which was higher than 35.66%of men;the mutation rate of adenocarcinoma was 49.79%,which was higher than 11.11%of squamous cell carcinoma(P<0.05).Compared with the corresponding tumor tissues,blood and pleural effusion had good consistency in the detection of EGFR mutations,and the Kappa values were 0.72 and 0.84,respectively.The mutation rate of T790 M in pleural effusion was 65.22%,which was higher than 52.17%in blood,but the difference was not statistically significant(P>0.05).Conclusion:The EGFR mutation rate in female and adenocarcinoma NSCLC patients is higher than that in male and squamous cell carcinoma patients.Compared with the corresponding tumor tissues,the detection of EGFR mutation in blood and pleural effusion has better consistency.For NSCLC patients who lose tissue biopsy,the EGFR mutation status can still be detected by blood and pleural effusion.More than 50%of patients can still benefit from third-generation TKIs

关 键 词：肺癌 EGFR 血液 胸腔积液 T790M 

分 类 号：R734.2[医药卫生—肿瘤]