EGFR基因突变各亚型及ALK基因融合与浸润性肺腺癌临床病理特征的关系  

Influence of EGFR gene mutation subtypes and ALK gene mutation on clinicopathological features of invasive lung adenocarcinoma

作　　者：成美英 王雅丽 王馨 偰燕燕 孙小迪 周永静 CHENG Meiying;WANG Yali;WANG Xin;XIE Yanyan;SUN Xiaodi;ZHOU Yongjing(Department of Oncology,the First People's Hospital of Zhenjiang City,Jiangsu Zhenjiang 212000,China)

机构地区：[1]镇江市第一人民医院肿瘤科,江苏镇江212000

出　　处：《现代肿瘤医学》2023年第20期3791-3795,共5页Journal of Modern Oncology

摘　　要：目的:探讨表皮生长因子受体(EGFR)突变各亚型及间变性淋巴瘤激酶(ALK)突变与浸润性肺腺癌临床病理特征的关系,旨在为浸润性肺腺癌临床诊治工作提供更多参考。方法:回顾性纳入2015年1月-2022年1月于我院接受手术治疗并经病理组织学检查确诊浸润性肺腺癌患者共547例,根据EGFR及ALK基因融合状态分组,比较各组临床病理特征资料,采用多因素Logistic回归模型评价EGFR基因突变各亚型及ALK基因融合发生相关独立预测因素。结果:单因素分析结果显示,EGFR基因突变组的年龄更大且女性比例、肿瘤最大径、实性成分最大径、实性成分占比≥50%比例及腺泡型比例显著多于野生组(P<0.05);EGFR基因突变组贴壁型比例显著低于野生组(P<0.05);ALK基因融合组年龄和女性比例显著低于野生组(P<0.05);ALK基因融合组吸烟比例、微乳头型比例、脏层胸膜侵犯比例、实性成分最大径及实性成分占比显著高于野生组(P<0.05);单因素分析结果显示,EGFR-exon21突变组肿瘤最大径显著长于野生组(P<0.05);EGFR-exon19突变组实性成分最大径显著长于野生组(P<0.05);EGFR-exon19突变组实性成分占比≥50%比例均显著高于野生组及EGFR-exon21突变组(P<0.05);EGFR-exon19突变组和EGFR-exon21突变组分叶征和胸膜牵拉征比例显著高于野生组(P<0.05);Logistic回归模型行多因素分析结果显示,女性和胸膜牵拉征是EGFR基因突变发生的独立预测因素(P<0.05);女性、实性成分占比、实性成分占比≥50%及分叶征是EGFR-exon19突变发生的独立预测因素(P<0.05);高龄、女性及更长肿瘤最大径是EGFR-exon21突变发生的独立预测因素(P<0.05);低龄、吸烟史、存在微乳头型成分及脏层胸膜侵犯是ALK基因融合的独立预测因素(P<0.05)。结论:伴EGFR基因突变及ALK基因融合浸润性肺腺癌存在独特临床病理特征,其中EGFR-exon19和21突变患者影像学改变存在明显差异;临床医�Objective:To investigate the influence of EGFR gene mutation subtypes and ALK gene mutation on clinicopathological features of invasive lung adenocarcinoma to provide more reference for clinical diagnosis and treatment of invasive lung adenocarcinoma.Methods:547 invasive lung adenocarcinoma patients received surgical treatment and diagnosed by histopathological examination were chosen in the period from January 2015 to January 2022 in our hospital.All patients were grouped according to EGFR and ALK gene mutation status and the clinicopathological characteristics of each group were compared.Multivariate Logistic regression model was used to evaluate the independent predictors of EGFR mutation subtypes and ALK gene fusion occurrence.Results:Univariate analysis showed that age,the proportion of female,the maximum diameter of tumor,the maximum diameter of solid component,the proportion of solid component≥50%and the proportion of acinar type in EGFR gene mutation group were significantly higher than wild group(P<0.05).The proportion of adherent type in EGFR gene mutation group was significantly lower than wild group(P<0.05).The age and female in ALK gene mutation group were significantly lower wild group(P<0.05).The proportion of smoking,micropapillary type,visceral pleural invasion,the maximum diameter of solid components and the proportion of solid components in ALK gene mutation group were significantly higher than wild group(P<0.05).Univariate analysis showed that the maximum tumor diameter in EGFR-Exon21 mutation group was significantly longer than wild group(P<0.05).The maximum diameter of solid component in EGFR-exon19 mutation group was significantly longer than wild group(P<0.05).The proportion of solid components≥50%in EGFR-exon19 mutation group were significantly higher than wild group and EGFR-exon21 mutation group(P<0.05).The proportion of leaf sign and pleural pull sign in EGFR-exon19 mutation group and EGFR-exon21 mutation group was significantly higher than wild group(P<0.05).Multivariate Logistic

关 键 词：表皮生长因子受体 间变性淋巴瘤激酶 肺腺癌 病理 影像学 

分 类 号：R734.2[医药卫生—肿瘤]