伴微乳头及实性成分的浸润性肺腺癌患者EGFR基因突变状态和临床病理特征的相关性  

The correlation between EGFR gene mutation status and clinical pathological characteristics in patients with invasive lung adenocarcinoma accompanied by micropapillary and solid components

作　　者：梅娜 骆莹滨 吴建春[1] 蒋雷[2] 田建辉[1] 李雁[1] MEI Na;LUO Yingbin;WU Jianchun;JIANG Lei;TIAN Jianhui;LI Yan(Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Shanghai Pulmonary Hospital,Shanghai 200433,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071 [2]上海市肺科医院,上海200433

出　　处：《现代肿瘤医学》2024年第21期4077-4083,共7页Journal of Modern Oncology

基　　金：国家自然基金面上项目(编号:82174183);上海医学创新发展基金会中医药科技发展项目(编号:WL-LXBB-2021001K,WL-HBQN-2021009K);上海市进一步加快中医药传承创新发展三年行动计划(2021年-2023年)(编号:ZY(2021-2023)-0211)。

摘　　要：目的:探讨伴微乳头及实体成分的浸润性肺腺癌EGFR基因突变状态及其临床病理特征。方法:回顾性筛选2018年09月至2023年03月就诊于上海市中医医院及上海市肺科医院808例术后病理为浸润性肺腺癌并行过基因检测的患者,根据是否伴有微乳头成分(micropapillary,MP)及实体成分(solid,SD)分为微乳头/实体型阳性组(MP/SD^(+))和微乳头/实体型阴性组(MP/SD-),又根据微乳头/实体型阳性组中微乳头及实体成分所占比例分为MP/SD^(+)(<10%)、MP/SD^(++)(10%~40%)、MP/SD^(++)+(>40%)三个亚组。用软件SPSS26.0分析基因突变情况与MP/SD状态以及与患者临床病理特征之间的关系。结果:808例患者中含有MP/SD成分的肺腺癌有396例(49%),MP/SD成分与性别、吸烟史、胸膜侵犯、脉管侵犯、胸腔播散、肿瘤大小、淋巴结转移、TNM分期、EGFR突变状态等有关。579例(71.7%)患者检测到有EGFR突变,81.6%的MP/SD阳性(323/396)组中存在EGFR突变,MP/SD^(+)组EGFR突变率高于MP/SD-组(P<0.001)。EGFR基因突变类型以19-del和L858R为主(占90%),突变类型在MP/SD三个亚组中无明显差异(P=0.51)。结论:伴微乳头、实性成分结构的肺腺癌EGFR突变频率高于不伴有微乳头、实性成分结构的肺腺癌。Objective:To investigate the EGFR gene mutation status in invasive lung adenocarcinoma with micropapillary and solid components and its clinicopathological characteristics.Methods:We retrospectively analyzed samples from 808 patients with invasive lung adenocarcinoma who were treated at the Shanghai Municipal Hospital of Traditional Chinese Medicine and Shanghai Pulmonary Hospital and underwent genetic testing from September 2018 to March 2023.The patients were categorized into the micropapillary/solid-positive group(MP/SD^(+))and micropapillary/solid-negative group(MP/SD-)according to the postoperative pathology results.Based on the proportions of solid and micropapillary components,the patients were categorized into three groups:MP/SD^(+)(<10%),MP/SD^(++)(10%~40%)and MP/SD^(++)+(>40%).The relationship of the gene mutation status with the MP/SD status and the clinicopathological characteristics was analyzed by SPSS26.0.Results:Among 808 patients,396(49%)patients with the MP/SD components.The MP/SD status was related to the gender,smoking history,pleural invasion,lymphovascular invasion,STAS,tumor size,lymph node metastasis,TNM stage and EGFR mutation status.EGFR mutation was detected in 579(71.7%)patients.The rate of EGFR mutation was 81.6%in the MP/SD-positive(323/396)group.The EGFR mutation rate in the(MP/SD^(+))group was higher than that in the(MP/SD-)group(P<0.001).The primary types of EGFR gene mutations were 19-del and L858R(90%).There was no significant difference among the three subgroups of MP/SD(P=0.510).Conclusion:The frequency of EGFR mutations in patients with lung adenocarcinoma with micropapillary and solid components was higher than that in patients with lung adenocarcinoma without micropapillary and solid components.

关 键 词：浸润性肺腺癌 微乳头 实性 EGFR基因突变 临床病理特征 

分 类 号：R734.2[医药卫生—肿瘤]