PD-1在非小细胞肺癌不同EGFR亚型表达的临床意义

发布时间：2018-04-21 23:29

本文选题：非小细胞肺癌 + EGFR基因型　；参考：《石河子大学》2017年硕士论文

【摘要】：目的:探讨PD-1在非小细胞肺癌中表皮生长因子EGFR基因检测不同亚型之间表达的差异性,探讨两者之间的关系及其表达与非小细胞肺癌浸润、转移和预后的关系。方法:收集新疆军区总医院共88例非小细胞肺癌患者病理标本,取肺癌癌组织和癌旁组织,采用PCR-ARMS测序法检测标本组织的EGFR基因突变亚型,采用免疫组织化学方法染色来检测PD-1的表达情况,分析PD-1表达情况在EGFR基因的不同亚型之间的表达程度,并且结合临床病理因素进行单因素和COX多因素生存分析。结果:(1)肺癌组织中PD-1的阳性表达率为63.64%,癌旁组织中PD-1的阳性表达率为21.59%,肺癌组织和癌旁组织间的表达存在差异性(P=0.008)。PD-1阳性表达情况在肿瘤淋巴结侵犯情况(P=0.010)和是否吸烟(P=0.024)之间的差异存在统计学意义;PD-1阳性表达情况与患者的性别、年龄、肿瘤直径分组、肿瘤分化程度、肿瘤浸润深度、TNM分期之间的差异没有统计学意义(P0.05)。(2)EGFR基因检测结果:突变型43例,野生型45例,突变率48.86%。肺癌组织中PD-1阳性表达在EGFR突变型野生型之间的差异无统计学意义(P0.05)。(3)43例突变型患者中19Del突变亚型为24例,PD-1阳性表达为20例,阳性率83.33%,21L858R突变亚型为19例,PD-1阳性表达10例,阳性率52.63%,交叉表分析PD-1在EGFR不同亚型之间的表达差异有统计学意义(P=0.029)。生存分析结果提示EGFR野生型中PD-1不同表达的患者生存期差异有统计学意义(P=0.024),EGFR突变型中PD-1不同表达的患者生存期差异无统计学意义(P0.05)。结论:(1)肺癌组织中PD-1蛋白的表达较癌旁组织明显增高,PD-1在癌组织中的表达与肺癌的增殖活性和侵袭性有关。(2)PD-1是预测肺癌患者生存时间的危险因素,其表达在非小细胞肺癌EGFR突变不同亚型之间存在差异,为19Del和21L858R作为两种不同类型的肺癌进行研究提供了证据。
[Abstract]:Objective: to investigate the difference of expression of epidermal growth factor (EGFR) gene in non-small cell lung cancer (NSCLC), and to explore the relationship between EGF EGFR gene expression and invasion, metastasis and prognosis of NSCLC. Methods: the pathological specimens of 88 patients with non-small cell lung cancer were collected from Xinjiang military region General Hospital. PCR-ARMS sequencing was used to detect the mutation subtypes of EGFR gene in lung cancer tissues and adjacent tissues. Immunohistochemical staining was used to detect the expression of PD-1, and the expression of PD-1 among different subtypes of EGFR gene was analyzed. Univariate and COX multivariate survival analysis was performed with clinicopathological factors. Results the positive expression rate of PD-1 was 63.64 in lung cancer and 21.59 in paracancerous tissue. There was a difference between lung cancer and paracancerous tissue. There was statistical significance between the positive expression of PD-1 and the sex of the patients. There was no significant difference in age, tumor diameter, tumor differentiation, tumor invasion depth and TNM stage. The results of EGFR gene detection were as follows: mutation type 43 cases, wild type 45 cases, mutation rate 48.86%. There was no significant difference between PD-1 positive expression and wild type of EGFR mutation in lung cancer. In 43 patients with EGFR mutation, there were 24 cases of 19Del mutation subtype and 20 cases of positive expression of 19Del mutation subtype. The positive rate was 83.33% 21 L858R mutation subtype 19 cases with positive expression of pPD-1 gene, and the positive rate of 19Del mutation subtype 21 L858R mutation was 19 cases with positive expression of pPD-1 in 10 cases. The positive rate was 52.63%. There was significant difference in the expression of PD-1 among different subtypes of EGFR by cross table analysis. Survival analysis showed that the survival time of patients with different expression of PD-1 in wild type of EGFR was significantly different. There was no significant difference in survival time of patients with different expression of PD-1 in EGFR wild type. Conclusion the expression of PD-1 protein in lung cancer tissues is significantly higher than that in adjacent tissues. The expression of PD-1 in lung cancer tissues is related to the proliferative activity and invasiveness of lung cancer, which is a risk factor for predicting the survival time of lung cancer patients. The expression of 19Del and 21L858R were different among different subtypes of EGFR mutation in non-small cell lung cancer (NSCLC), which provided evidence for the study of 19Del and 21L858R as two different types of lung cancer.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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