754例Ⅰ期-Ⅲa期可手术切除非小细胞肺癌患者EGFR和KRAS基因突变状态及其临床意义

发布时间：2018-03-01 22:12

本文关键词： 肺肿瘤 EGFR基因 KRAS基因可手术切除标本　出处：《中国肺癌杂志》2017年09期 　论文类型：期刊论文

【摘要】：背景与目的表皮生长因子受体(epidermal growth factor receptor,EGFR)和KRAS基因是非小细胞肺癌(non-small cell lung cancer,NSCLC)重要的分子靶点,但目前研究主要集中在晚期NSCLC组织和血浆标本的EGFR检测,早期NSCLC组织样本中EGFR和KRAS突变特征尚不清楚。本研究将探讨I期-IIIa期NSCLC EGFR和KRAS基因突变与相关临床病理特征的关系。方法采用突变扩增系统(amplification refractory mutation system,ARMS)PCR方法检测北京协和医院病理科提供的754例I期-IIIa期NSCLC组织样本的EGFR和KRAS基因突变状况,分析基因突变率及其与临床病理特征的关系。结果 EGFR和KRAS基因热点突变的突变率分别为34.5%和13.1%,其中有3例样本具有EGFR和KRAS基因的双突变。EGFR基因在女性中的突变率高于男性(39.5%vs 29.4%,P=0.076),在腺癌中的突变率(38.7%)高于鳞癌、腺鳞癌、大细胞癌(P0.01),但仍明显低于其他研究报道的亚裔晚期腺癌突变率(-50%)。KRAS基因突变在男性中的突变率高于女性(16.6%vs 9%,P=0.048),且在腺癌中的突变率也高于其他类型,但差异不显著(P=0.268)。与KRAS基因突变阳性组相比,EGFR基因突变阳性组在年龄分布上有年轻化的趋势(P=0.031,5),在性别分布上有显著性差异(P0.01)。结论 I期-IIIa期NSCLC EGFR基因突变率较晚期患者低,且EGFR和KRAS基因双突变的发生率为0.9%。
[Abstract]:Background & objective Epidermal growth factor receptor (EGFR) and KRAS gene are important molecular targets for non-small cell lung cancer in non-small cell lung cancer (NSCLC). The characteristics of EGFR and KRAS mutations in early NSCLC tissue samples are not clear. This study will explore the relationship between NSCLC EGFR and KRAS gene mutations in phase I-IIIa and the clinicopathological features. The mutation status of EGFR and KRAS gene in 754 cases of stage I -IIIa NSCLC tissue samples provided by Department of Pathology of Peking Union Hospital. Results the mutation rates of hot spot mutations in EGFR and KRAS genes were 34.5% and 13.1respectively. Among them, 3 samples had double mutations of EGFR and KRAS genes. EGFR gene mutation in women. The mutation rate in adenocarcinoma was 38.7% higher than that in squamous cell carcinoma. The mutation rate of KRas gene was significantly lower in men than in women (16.6 vs 9.048), but still significantly lower than that reported in other studies, and the mutation rate in adenocarcinoma was also higher than that in other types of adenocarcinoma. But the difference was not significant (P < 0. 268). The age distribution of KRAS gene mutation positive group was younger than that of KRAS gene mutation positive group, and there was significant difference in sex distribution. Conclusion the mutation rate of NSCLC EGFR gene in stage I stage is lower than that in late stage group. The incidence of double mutations in EGFR and KRAS genes was 0.9g.
【作者单位】：中国医学科学院北京协和医学院北京协和医院呼吸科;中国医学科学院北京协和医学院北京协和医院病理科;大连晶泰医学检验所;北京宏微特斯生物科技有限公司;
【分类号】：R734.2

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