非小细胞肺癌患者细胞学标本EGFR基因突变检测及其临床病理意义

发布时间：2018-02-26 16:50

本文关键词： 细胞学标本免疫细胞化学非小细胞肺癌突变扩增阻滞系统 EGFR基因突变检测　出处：《癌变·畸变·突变》2016年01期 　论文类型：期刊论文

【摘要】：目的:探讨细胞学标本在非小细胞肺癌(NSCLC)的诊断及个体化治疗中的临床应用价值。方法:收集352例新鲜细胞学标本制片后,行常规HE染色;同时选择TTF-1、NapsinA、CK7、CEA、CD56、Syn、P63、CK5/6、WT-1、E-cadherin等抗体对来源不明的肿瘤细胞进行免疫细胞化学标记,并对明确诊断为NSCLC的病例,采用突变扩增阻滞系统(ARMS)检测表皮生长因子受体(EGFR)基因突变情况。结果:352例患者中,345例有癌细胞。经临床及免疫细胞化学证实345例恶性细胞中,NSCLC有335例,且NSCLC细胞学标本中有302例DNA提取成功,占90.15%(302/335)。EGFR基因检测结果显示,EGFR共突变123例,总突变率为40.73%(123/302)。其中,第18、19、20、21外显子的突变率分别为0.99%(3/302)、19.21%(58/302)、0.66%(2/302)和19.87%(60/302);EGFR 18、19、21外显子突变占EGFR突变总数的98.37%(121/123)显著高于EGFR 20外显子突变(P0.05)。302例患者中,女性患者EGFR突变率为54.35%(75/138),明显高于男性患者29.27%(48/164)(P0.05);非吸烟患者EGFR的突变率为51.49%(104/202),显著高于吸烟者19%(19/100)(P0.05)。276例腺癌中EGFR突变率44.20%(122/276);非腺癌EGFR突变率4.34%(1/23);腺癌EGFR突变率明显高于其他类型(P0.05)。结论:利用新鲜细胞学标本,结合免疫细胞化学标记和ARMS分子病理技术有助于晚期非小细胞肺癌的诊断,并为表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)个体化治疗提供可靠依据。
[Abstract]:Objective: to evaluate the clinical value of cytological specimens in the diagnosis and individualized treatment of NSCLC. At the same time, antibodies such as TTF-1 Napsinin ACK7 CEAN CD56An SynP63CK5 / 6 WT-1T E-cadherin were used to label tumor cells of unknown origin, and the cases diagnosed as NSCLC were confirmed. The mutation of epidermal growth factor receptor (EGFR) gene was detected by mutation amplification block system (ARMS). Results 345 of 352 patients had cancer cells, 335 of 345 malignant cells were confirmed by clinical and immunocytochemistry. In addition, 302 cases of NSCLC cytological samples were successfully extracted, accounting for 90.15% of 302 / 335.EGFR gene mutation in 123 cases, and the total mutation rate was 40.73% 123,302%. The mutation rate of exon 1819 / 20 / 21 was 0.9999 / 3 / 302c / 19.21 / 0.66 / 302) and 19.8760 / 302EGFR181211 / 123 / 302, respectively, which was significantly higher than that of EGFR 20 exon mutation (P0.05 / 302), which was higher than that of EGFR 20 exon mutation (P0.05 / 302), and was significantly higher than that of EGFR 20 exon mutation (P0.05 / 302), which accounted for 98.371212 / 123 of the total exon number of EGFR mutations, and was significantly higher than that of EGFR 20 exon mutation (P0.05 / 302). The mutation rate of EGFR in female patients was 54.35% 75 / 138g, which was significantly higher than that in male patients (29.27 / 164), and the mutation rate of EGFR in non-smoking patients was 51.49 / 104 / 2022, which was significantly higher than that in smokers (194.20 / 100 / 0.05 / 276). The EGFR mutation rate was 44.20 / 1222 / 276C; the EGFR mutation rate of non-adenocarcinoma was 4.3445%; the mutation rate of EGFR in adenocarcinoma was significantly higher than that of other types. Conclusion: using fresh cytological specimens, The combination of immunocytochemical labeling and ARMS molecular pathology is helpful to the diagnosis of advanced non-small cell lung cancer and provides reliable evidence for individualized treatment of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TK Isa).
【作者单位】：河北医科大学第四医院癌检中心;
【基金】：河北省科技厅项目(14277782D)
【分类号】：R734.2

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