摘要
目的:通过免疫组织化学染色与实时荧光定量PCR检测表皮生长因子受体(EGFR)突变的比较,探讨两种检测方法的一致性及在非小细胞肺癌(NSCLC)临床检测中的应用价值。方法:随机选择36例NSCLC存档石蜡组织,采用特异性突变抗体(E746-A750del和L858R)的免疫组织化学染色方法和Roche商品化的cobas?EGFR PCR检测试剂盒检测EGFR的突变状态。结果:EGFR突变蛋白阳性定位于肿瘤细胞质和或胞膜。免疫组织化学检测显示NSCLC中EGFR突变阳性率为47.22%(17/36),其中鳞癌的突变率为9.09%(1/11),腺癌的突变率为64.00%(16/25),二者的差异有显著性(P<0.05)。实时荧光定量PCR检测NSCLC中EGFR突变阳性率为50.00%(18/36),其中鳞癌的突变率为18.18%(2/11),而腺癌的突变率为64%(16/25),二者的差异有显著性(P<0.05)。免疫组织化学染色与实时荧光定量PCR检测EGFR突变具有极好的一致性(κ=0.833,P<0.01),并且检测到的主要突变位点都是19号外显子的缺失突变(E746-A750del)和21号外显子的点突变(L858R)。结论:EGFR突变特异性抗体的免疫组织化学检测是一种可在NSCLC中进行EGFR突变筛查并对EGFR-TKI治疗快速反应的方法,具有检测费用较低、检测时间较短且结果易于判读,是一种可以在临床进行广泛推广的检测方法。EGFR突变在肺腺癌中更为常见。
Objective： To compare the consistency of immunohistochemistry and quantitative real-timePCR in detecting EGFR mutations, and to investigate their applications in the diagnosis of non- small cell lung cancer （NSCLC）. Methods. EGFR mutation was assayed by immunohistochemistry using mutation-specific antibody （E746-A750del and L858R） and Roche cobas EGFR PCR detection kit in the randomly selected 36 cases of archived NSCLC tissues. Results. EGFR mutations protein was localized in the cytoplasm and cell membrane of tumor cells. Immunohistochemical analysis showed that positive rates of EGFR mutation in the NSCLC tissues was 47. 22 （17/36）, in which the mutation rate was 9.09% of squamous cell carcinoma （1/11）, while the mutation rate of adenocarcinoma was 64.00% （16/25） with significant difference （P〈0.05）. Positive rate of EGFR mutations detected by quantitative real-time PCR in the NSCLC tissues was 50.00% （18/36）, in which mutation rate was 18.18〈 in squamous cell carcinoma （2/11） versus 64 % in adenocarcinoma （16/25） （P〈 0.05）. Immunohistochemistry and quantitative realtime PCR to detect EGFR mutations had excellent consistency （k= 0. 833, P〈0.01）, and major mutations detected by the two methods were delE746-A750 in exon 19 and L858R in exon 21. Conclusion. IHC with mutation-specific mAbs against EGFR is a promising and reliable prescreening method for EGFR mutations detection and rapid response EGFR-TKI therapy in NSCLC patients, and is inexpensive, rapid and easy for diagnosis. EGFR mutations in lung adenocarcinoma is more common.
出处
《武汉大学学报（医学版）》
CAS
北大核心
2014年第4期541-545,共5页
Medical Journal of Wuhan University
基金
国家自然科学基金资助项目(编号:30900652)
