摘要
目的研究非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)基因突变与样本来源关系。探讨组织样本、血液样本及恶性胸腔积液样本检测EGFR基因突变的可行性及可靠性。方法收集锦州医科大学附属第一医院胸外科、肿瘤内科及普外科2013年7月1日至2016年7月1日NSCLC患者的组织样本157例、血液样本23例和胸腔积液样本20例。其中男性127例,女性73例;年龄35~82岁,平均年龄61岁。≤61岁67例,>61岁133例。采用E.Z.N.A.TM Tissue DNA Kit提取组织样本DNA,Human EGFR Gene Mutation Fluorescence Polymerase Chain Reaction(PCR)Diagnostic Kit提取血液及恶性胸腔积液样本DNA,使用荧光定量RCR进行EGFR检测。结果 157例组织样本EGFR基因突变率为42.7%(67/157),23例血液样本EGFR基因突变率为34.8%(8/23),胸腔积液样本EGFR基因突变率为80.0%(16/20)。组织样本中,EGFR基因突变率在不同性别(χ~2=1.837,P=0.274)、不同年龄(χ~2=0.645,P=0.247)、TNM分期(χ~2=1.645,P=0.427),各组间差异无统计学意义;吸烟和非吸烟患者差异有统计学意义(χ~2=2.674,P=0.036);手术切除样本和活检样本EGFR基因突变率差异无统计学意义(χ~2=2.165,P=0.374);转移灶EGFR基因突变率高于原发灶,差异有统计学意义(χ~2=4.148,P=0.043)。腺癌EGFR基因突变率高于非腺癌,差异有统计学意义(χ~2=5.274,P=0.021)。结论 NSCLC患者EGFR基因突变率在腺癌人群中高发,与不同性别、年龄、TNM分期、吸烟,身体状态无关;转移灶较原发灶高,有胸腔积液患者较无胸腔积液患者高;腺癌患者高于非腺癌患者。由于肿瘤异质性的存在,应早期尽可能获取不同部位(原发灶和转移灶)、不同部分的肿瘤组织用于检测。在不能获取肿瘤组织样本时,也可以用患者的血液或者胸腔积液样本来代替。
Objective To study the relationship between mutation of epidermal growth factor receptor（EGFR） gene of patients with non-small cell lung cancer（NSCLC） and origin of sample, and discuss the feasibility and reliability of tissue sample, blood sample and malignant pleura1 effusion sample in detection of EGFR gene mutation. Methods From July 1, 2013 to July 1, 2016, a total of 157 tissue samples, 23 blood samples and 20 malignant pleural effusion samples of NSCLC patients from Department of Thoracic Surgery, Oncology and General Surgery in First Affiliated Hospital of Jinzhou Medical University were collected. The patients included 127 males and 73 females, aged 35 - 82 years old with mean age of 61 years old, 67 cases ≤ 61-year-old and 133 cases 〉 61-year-old. The E.Z.N.A.^TM Tissue DNA Kit（OMEGA company） was used to extract DNA of tissue sample, the Human EGFR Gene Mutation Fluorescence Polymerase Chain Reaction（PCR） Diagnostic Kit was used to extract the DNA of blood sample and malignant pleural effusion sample, and fluorescent quantitation RCR was used to detect the EGFR. Results The EGFR gene mutation rate of tissue samples was 42.7 %（67/157）, blood samples was 34.8 % and leural effusion sample was 80.0 %（16/20）. The EGFR gene mutation rates of tissue samples were different in different gender（Х^2 = 1.837, P = 0.274）, different age（Х2 = 0.645, P = 0.247） and TNM staging（Х^2 = 1.645, P = 0.427）, and there was no significant difference between the groups. The differences in smoking and non-smoking patients were statistically significant（Х^2 = 2.674, P = 0.036）. There was no significant difference in EGFR gene mutation rates between gross and punctured samples（Х^2 = 2.165, P = 0.374）. The EGFR gene mutation rate of metastatic was higher than that of primary tumor, and the difference was statistically significant（Х^2 = 4.148, P = 0.043）. The EGFR gene mutation rate of adenocarcinoma was higher than that of non-adenocarcinoma, and the difference was statistica
作者
蒋磊
李玉强
孙宏治
李谌
JIANG Lei LI Yu-qiang SUN Hong-zhi LIChen(Department of Cenerol Surgery Molecular Detection Center, Clinical Biological Sample Center, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121001, Liaoning, China)
出处
《生物医学工程与临床》
CAS
2017年第3期308-314,共7页
Biomedical Engineering and Clinical Medicine
基金
国家自然科学基金资助项目(81672961)
关键词
非小细胞肺癌
表皮生长因子受体
基因突变
胸腔积液
恶性
组织样本
血液循环游离DNA
non-small cell lung cancer（NSCLC）
epidermal growth factor receptor（EGFR）
gene mutation
pleural effusion, malignant
tissue sample
circulating free DNA
