炎性标志物与肺腺癌表皮生长因子受体突变及病理亚型的关系  

Correlation of inflammatory markers with epidermal growth factor receptor gene mutation and pathological subtypes in lung adenocarcinoma

作　　者：徐乐乐 许哲源[2] 张利斌[2] 汪洋 王含 刘俊[2] 陈云 彭浩[2] XU Lele;XU Zheyuan;ZHANG Libin;WANG Yang;WANG Han;LIU Jun;CHEN Yun;PENG Hao(Medical School,Kunming University of Science and Technology,Kunming 650000,Yunnan,China;Department of Thoracic Surgery,the First People’s Hospital of Yunnan Province,Kunming 650200,Yunnan,China)

机构地区：[1]昆明理工大学医学院,昆明650000 [2]云南省第一人民医院胸外科,昆明6502000

出　　处：《癌症进展》2022年第7期684-687,共4页Oncology Progress

摘　　要：目的探讨肺腺癌患者术前外周血中血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)与表皮生长因子受体(EGFR)突变及病理亚型的关系。方法收集109例行肺癌根治术且术后接受驱动基因二代测序肺腺癌患者的临床资料及EGFR突变状态,其中EGFR突变型患者56例,EGFR野生型患者53例,分析术前患者NLR、PLR、LMR与EGFR突变状态以及不同病理亚型之间的关系。结果EGFR突变型肺腺癌患者中女性、年龄≥65岁、无吸烟史及浸润性腺癌(IAC)比例均高于EGFR野生型患者,差异均有统计学意义(P﹤0.05)。EGFR突变型肺腺癌患者NLR明显低于EGFR野生型患者,LMR明显高于EGFR野生型患者,差异均有统计学意义(P﹤0.01)。Logistic回归分析结果显示,年龄≥65岁、无吸烟史、病理亚型为IAC、低NLR均为肺腺癌EGFR突变的危险因素(P﹤0.05)。原位腺癌(AIS)患者LMR高于微浸润性腺癌(MIA)及IAC患者,差异均有统计学意义(P﹤0.05)。结论肺腺癌患者EGFR突变与性别、年龄、吸烟史及病理亚型具有一定关系,且常见于女性、≥65岁、无吸烟史、IAC患者。NLR和LMR在鉴别肺腺癌EGFR突变及病理亚型方面有一定的参考价值。Objective To investigate the correlation of platelet to lymphocyte ratio(PLR),neutrophil to lymphocyte ratio(NLR)and lymphocyte to monocyte ratio(LMR)with epidermal growth factor receptor(EGFR)gene mutation and pathological subtypes in preoperative peripheral blood of patients with lung adenocarcinoma.Method The clinical data and EGFR gene mutation status of 109 patients with lung adenocarcinoma who underwent radical resection of lung cancer and next generation sequencing(NGS)after operation were collected,including 56 EGFR mutant patients and 53EGFR wild type patients.The correlation of NLR,PLR,and LMR with EGFR mutation status and different pathological subtypes were analyzed.Result The proportion of females,ages≥65 years old,non-smokers and invasive adenocarcinoma(IAC)in EGFR mutative lung adenocarcinoma was higher than that with wild type EGFR mutation(P<0.05);the NLR was lower,LMR higher than that with wild type EGFR mutation(P<0.01).Logistic regression analysis showed that ages≥65 years old,non-smokers,IAC subtype and low NLR were independent risk factors for EGFR mutation in patients with lung adenocarcinoma(P<0.05);the LMR of patients with adenocarcinoma in situ(AIS)was higher than those with minimally invasive adenocarcinoma(MIA)and IAC(P<0.05).Conclusion EGFR mutation of patients with lung adenocarcinoma is associated with gender,age,smoking history and subtype,and is common in females,≥65 years old,non-smokers and IAC patients.NLR and LMR have some reference value in differentiating EGFR gene mutation and pathological subtype of lung adenocarcinoma.

关 键 词：肺腺癌 表皮生长因子受体 淋巴细胞与单核细胞比值 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 

分 类 号：R734.2[医药卫生—肿瘤]