摘要
目的探讨表皮生长因子受体(epithelial growth factor receptor,EGFR)突变特异性抗体在肺腺癌中的表达及其意义。方法应用免疫组织化学(immunohistochemistry,IHC)法检测171例已知EGFR突变情况[扩增阻滞突变系统-PCR(amplification refractory mutation system-PCR,ARMS-PCR)法检测]的肺腺癌中EGFR基因19、21号外显子突变特异性蛋白(EGFR-19、EGFR-21)和非突变蛋白(EGFR-P)的表达,分析EGFR-19、21表达与临床病理特征的关系,检验IHC与ARMS-PCR法检测结果的一致性。结果 EGFR突变蛋白表达与低分化腺癌(微乳头型、实体型)有关(P=0.021);EGFR-21高表达与肿瘤侵犯胸膜有关(P=0.005)。IHC法检测EGFR-19、21表达与ARMS-PCR法检测EGFR突变具有一致性(Kappa值均>0.4);EGFR-19、21的敏感性、特异性分别为65.0%、89.4%和70.0%、97.6%。结论肺腺癌中EGFR突变蛋白表达与组织分化差、胸膜侵犯有关,提示其可作为预后不良的指标;IHC法检测EGFR突变特异性蛋白可用作EGFR突变初筛手段。
Purpose To investigate the expression and significance of epidermal growth factor receptor (EGFR) mutation-specific anti- bodies in lung adenocarcinoma. Methods Immunohistochemical (IHC) technique was used to detect the expression of EGFR muta- tion-specific antibodies ( EGFR-19, EGFR-21 ) and EGFR total protein antibody (EGFR-P) in 171 cases of lung adenocarcinoma with resected specimens, and EGFR gene mutation was also performed by amplification refractory mutation aystem-PCR (ARMS-PCR). The expression of EGFR-19, EGFR-21 and EGFR-P mutant proteins was compared with EGFR gene mutation and their relationship with histological classification and clinical characteristics were analyzed. Results The expression of EGFR mutant protein was correlated with the poor differentiation group including micropapillary and solid predominant types ( P = 0. 021 ). EGFR-21 high expression was related to pleural invasion (P = 0. 005 ). The coherence of IHC (with EGFR-19/21 antibodies) and ARMS-PCR was existed (Kappa 〉0.4). Taking ARMS-PCR as a standard, the sensitivity and specificity of EGFR-19 and EGFR-21 were 65.0% and 89.4%, 70. 0% and 97.6%, respectively. Conclusions Expression of EGFR mutation-specific antibodies is associated with poor differentia- tion and pleural invasion. It suggests a worse prognosis indicator in lung adenocarcinoma. Because of the coherence with ARMS-PCR, using IHC with mutation-specific antibodies to detect the mutant proteins of EGFR-19/21 may act as a preliminary screening method of EGFR gene mutation.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2015年第6期652-656,共5页
Chinese Journal of Clinical and Experimental Pathology
关键词
肺肿瘤
腺癌
EGFR
特异性抗体
免疫组织化学
lung neoplasms
adenocarcinoma
epidermal growth factor receptor
mutation-specific antibody
immunohistochemistry