40岁以下非小细胞肺癌中EGFR突变状态和PD-L1的表达  

EGFR Mutation Status and PD-L1 Expression in Patients≤40 Years Old with NSCLC

作　　者：胡明明[1] 刘子臣[2] 张红梅[1] 鲁葆华[1] 李杰[1] 王群慧[1] 胡范彬[1] 林海峰 李宝兰[1] 张同梅[1] HU Mingming;LIU Zichen;ZHANG Hongmei;LU Baohua;LI Jie;WANG Qunhui;HU Fanbin;LIN Haifeng;LI Baolan;ZHANG Tongmei(Department of Oncology,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;Department of Pathology,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院肿瘤内科,北京101149 [2]首都医科大学附属北京胸科医院病理科,北京101149

出　　处：《肿瘤防治研究》2022年第7期687-691,共5页Cancer Research on Prevention and Treatment

摘　　要：目的回顾性分析47例手术切除的青年NSCLC患者的临床资料、EGFR突变特点和PD-L1的表达,了解这一群体的临床病理特点和分子特征。方法收集2014年1月—2019年12月于首都医科大学附属北京胸科医院行手术切除的年龄≤40岁的NSCLC患者,使用R语言进行倾向性评分,并按1:2匹配94例老年NSCLC患者的手术标本(≥60岁),采用ARMS-PCR检测EGFR突变,免疫组织化学方法检测PD-L1的表达。结果47例青年NSCLC患者的中位年龄为37岁,女性多见,腺癌为主。与老年组相比,青年组19外显子缺失(19del)和20外显子插入(20ins)比例更高,老年组21外显子L858R点突变比例更高。实体亚型成分为主的腺癌PD-L1阳性率明显增高。分组分析显示,青年组19del组PD-L1表达高于L858R组,老年组两种突变类型之间PD-L1表达差异无统计学意义。结论青年NSCLC以女性、腺癌、不吸烟患者为主,EGFR 19del和20ins构成比例高。实体型成分为主的腺癌PD-L1阳性率高于其他亚型。青年组EGFR 19del患者PD-L1表达高于L858R患者。Objective To retrospectively analyze the clinical data of 47 young NSCLC patients mutation style of EGFR and PD-L1 expression in tumor cells,to understand their clinicopathological and molecular characteristics.Methods We enrolled 47 young(≤40 years old)patients confirmed as NSCLC who underwent surgical resection,and 94 old patients(≥60 years old)were matched as 1:2 by R language.EGFR mutation status was detected by ARMS-PCR,and the expression of PD-L1 was detected by immunohistochemistry.Results The median age of 47 young patients with NSCLC was 37 years old.The disease was more common in women and the majority type was adenocarcinoma.In youth group,the 19del and 20ins were more frequent,but the exon 21 L858R point mutation proportion was higher in elder group.The expression of PD-L1 was significantly increased in the solid predominant histological subtype.The PD-L1 expression in 19del patients was higher than that in the patients with L858R mutation in youth group.Conclusion The majority of young NSCLC patients are female,nonsmokers and suffered from adenocarcinoma cancer.The proportion of EGFR alteration in 19del and 20ins in youth group is higher than that in elder group.The positive rate of PD-L1 expression in solid predominant histological subtype is higher than that with other subtypes.The expression of PD-L1 in young patients with EGFR 19del is higher than that with L858R.

关 键 词：非小细胞肺癌 青年 EGFR PD-L1 

分 类 号：R734.2[医药卫生—肿瘤]