摘要
目的探讨肺微浸润性腺癌表皮生长因子受体(EGFR)基因突变特征及意义,比较不同EGFR基因突变状态患者之间的临床病理特征差异,为肺微浸润性腺癌分子分型的必要性提供依据。方法扩增阻滞突变系统多聚酶链式反应(ARMS-PCR)检测79例手术切除肺微浸润性腺癌组织中EGFR基因突变情况;分析比较EGFR野生型与突变型、外显子19与21突变型患者之间的临床病理特征。结果肺微浸润性腺癌EGFR基因突变率为75.95%,最常见突变类型为19Del(35.44%)及L858R(37.97%)。肺微浸润性腺癌中EGFR突变与微浸润成分组织学亚型、肿瘤内纤维化及免疫细胞浸润显著相关(P<0.01)。亚组分析显示19Del或L858R突变均与肿瘤大小、浸润灶最大径、肿瘤内纤维化及免疫细胞浸润情况显著相关(P<0.01,P<0.05)。19Del多好发于病灶≤1 cm、浸润灶最大径≤0.2 cm、肿瘤内缺乏纤维化及免疫细胞浸润的患者(P<0.01);L858R则相反(P<0.01)。结论不同EGFR基因状态的肺微浸润性腺癌具有显著不同的临床病理特征。根据EGFR基因突变特征对肺微浸润性腺癌进行分子分型,对于肿瘤预后评估及临床处理具有潜在意义。
Objective To determine epidermal growth factor receptor（ EGFR） mutation characteristics and explore their significances in patients with resected lung microinvasion adenocarcinoma（ MIA）,also intend to compare clinicopathological differences among EGFR mutation subtypes. Methods EGFR mutations of 79 surgically resected lung MIAs were evaluated by amplification refractory mutation system-real time polymerase chain reaction（ ARMS-PCR）. The present study compared the clinicopathological features between EGFR wild and mutant type as well as 19 Del and L858 R subtype. Results EGFR mutations were detected in 75. 95% of 79 lung MIAs and the most common mutation subtypes were 19 Del（ 35. 44%） and L858 R（ 37. 97%）. EGFR mutations in lung MIA were significantly associated with subtype of microinvasion component,intratumoral fibrosis and immune cell infiltration（ P〈0. 01）. Subgroup analysis indicated that there was a close association between 19 Del or L858 R and tumor size,maximum diameter of microinvasion,status of intratumoral fibrosis and immune cell infiltration（ P〈0. 01,P〈0. 05）. 19 Del occurred more frequently in MIA with smaller tumor size,smaller microinvasion area and without intratumoral fibrosis as well as immune cell infiltration（ P〈0. 01）. The opposite results were observed for L858 R（ P〈0. 01）. Conclusion Lung MIAs harboring different EGFR gene status show distinctive clinicopathological features. The molecular subclassification based on EGFR mutations may exert potential significances for prognostic evaluation and clinical management of MIA.
作者
李明
柯立
李传应
詹玛琍
程民
Li Ming;Ke Li;Li Chuanying(Dept of Pathology;Dept of Thoracic Surgery,The First Affiliated Hospital of USTC,Division of Life Science and Medicine,University of Science and Technology of China,Hefei 230001)
出处
《安徽医科大学学报》
CAS
北大核心
2018年第9期1447-1452,共6页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金青年基金(编号:81602605)
关键词
表皮生长因子受体
微浸润性腺癌
分子分型
epidermal growth factor receptor
microinvasion adenocarcinoma
molecular classification
