细胞蜡块、肺原发灶和转移灶组织在肺腺癌EGFR/ALK/ROS1基因联合检测中的应用  

Application of cell wax mass,lung primary and metastatic tissue in combined detection of EGFR/ALK/ROS1 gene in lung adenocarcinoma

作　　者：余清[1] 杨志蓉 王宪伟 徐培[1] 何小艳[1] YU Qing;YANG Zhirong;WANG Xianwei;Xu Pei;HE Xiaoyan(Department of Pathology,Deyang People′s Hospital,Deyang,Sichuan 618000,China)

机构地区：[1]德阳市人民医院病理科,四川德阳618000

出　　处：《临床肺科杂志》2023年第9期1331-1334,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨用457例肺腺癌患者的不同样本进行EAR(EGFR/ALK/ROS1)基因联合检测的意义。方法纳入2020年1月至2022年8月经病理确诊为肺腺癌患者457例,分别对415例肺组织标本(131例活检标本和284例手术切除标本)、32例浆膜腔积液细胞蜡块、10例转移灶组织进行EAR基因联合检测,比较肺组织标本与细胞蜡块、转移灶组织EAR基因异常检出情况。结果(1)457例肺腺癌患者EAR突变总检出率为64.3%(294/457),EGFR/ALK/ROS1分别为56.2%(257/457)、4.8%(22/457)、3.3%(15/457);肺组织标本、细胞蜡块、转移灶组织EAR基因检出率分别为:62.7%(260/415)、84.4%(27/32)、70.0%(7/10),三者数据检出率存在着统计学差异(P<0.05),其中细胞蜡块与肺活检组织检出率相比,有统计学差异(P<0.017)。(2)131例活检标本与284例手术切除标本EAR基因检出率分别为52.7%(69/131)、67.3%(191/284),手术切除标本比活检标本有更高的EAR基因检出率,差异有统计学意义(P<0.05)。结论细胞蜡块在EAR基因检测方面具有最高的突变检出率,当肺腺癌患者临床难以获取活检组织时,可以替代用于基因检测;肺手术切除标本比活检标本有更高的EAR基因突变检出率。Objective To explore the significance of combined detection of the EAR(EGFR/ALK/ROS1)gene in 457 patients with different samples of lung adenocarcinoma.Methods A total of 457 patients with pathological diagnosis of lung adenocarcinoma were included from January 2020 to August 2022,and EAR gene combined detection was performed on 415 lung tissue specimens(131 biopsy specimens and 284 surgical excisional specimens),32 serosal effusion cell wax mass,and 10 metastatic tissues,respectively.The abnormal detection of the EAR gene in lung tissue samples was compared with that in cell wax mass and metastases.Results The total detection rate of EAR mutation in 457 patients with lung adenocarcinoma was 64.3%(294/457),EGFR/ALK/ROS1 was 56.2%(257/457),4.8%(22/457),and 3.3%(15/457),respectively.The detection rates of the EAR gene in lung tissue specimen,cell wax block,and metastatic tissue were as follows:There were statistical differences in the detection rates of 62.7%(260/415),84.4%(27/32),and 70.0%(7/10)among the three data(P<0.05),and there were statistical differences between the detection rates of cell wax blocks and lung biopsy tissues(P<0.017).The EAR gene detection rates of 131 biopsy specimens and 284 surgical excision specimens were 52.7%(69/131)and 67.3%(191/284),respectively.Surgical excision specimens had a higher EAR gene detection rate than biopsy specimens,and the difference was statistically significant(P<0.05).Conclusion Cell wax blocks have the highest mutation detection rate in EAR gene detection and can be used for gene detection when it is difficult to obtain biopsy tissue in lung adenocarcinoma patients.The EAR gene mutation detection rate was higher in lung resection specimens than in biopsy specimens.

关 键 词：细胞蜡块 肺腺癌 (EGFR/ALK/ROS1)基因联合检测 转移灶组织 活检标本 手术切除标本 

分 类 号：R734.2[医药卫生—肿瘤]