肺癌与表皮生长因子及其受体关系的研究

The study on the correlation between EGF,EGFR and lung carcinoma

目的观察肺良性疾病、原发性肺癌患者表皮生长因子(EGF)及其受体(EGFR)在组织中不同表达及其与预后的关系。方法采用用免疫组化(IHC)法检测患者EGFR的表达；用放射免疫分析(RIA)法测定患者EGF的动态变化,并对肺癌患者进行随访。结果EGFR在非小细胞肺癌(NSCLC)中表达88%(80/91),在癌旁组织中(距肿瘤边缘3cm以内)表达64%(58/91),较肺良性疾病(10%,10/95)高,差异有显著性意义(t=4．0,P＜0．01),而距肿瘤边缘6cm以远的正常肺组织表达12%(11/91),与肺良性疾病差异无显著性意义(t=2．8,P＞0．05)；小细胞肺癌不表达EGFR。肺癌患者术前血中EGF较肺良性疾病高,术后明显下降。EGFR表达阳性的NSCLC患者,术前EGF较阴性组高,术后逐渐下降,复发前、复发后升高,接近术前水平；EGFR表达阳性的NSCLC患者,术后6、12、18、24个月复发率分别为10%、55%、70%、81%,而EGFR表达阴性的复发率分别是0、13%、37%、50%。结论EGFR与肺癌预后关系密切。

Objective To detect and observe the different expression and the prognosis relation between epidermal growth factor （EGF） and epidermal growth factor receptor （EGFR） in benign lung disease and primary lung carcinoma. Methods To detect EGFR by immunohistochemical （IHC） ABC method. To test and follow-up survey the changes of EGF in lung cancer patients by radioimmunoassay（RIA）. Results The level of EGFR in non-small cell lung carcinoma （NSCLC） was 88% （80/91）, in tissues （3 centimetres nearby tumor） was 64%（58/91）, in benign lung disease was 10% （4/39） （t=4.73, P〈0.01）. The level of EGFR in normal lung tissues （6 centimetres nearby tumor） was 12%（11/91）, but these was no significante difference with benign lung disease （t=2.8, P〉0.05）. EGFR was not tested in NSCLC. Before operation, the level of EGF in lung cancer patients was higher than that of benign lung patients, but it decreased after operation. The EGF in NSCLC with positive EGFR pre-operation was higher than that of negative EGFR, but it decreased post operation, while pre and post-recurrence it increased approaching the pre-operation level. NSCLC patients with positive EGFR, the recurrence rate was 16%, 55%, 70% and 81% a second time 6, 12, 18 and 24 months after operation, while the recurrence rate with negative EGFR was 0, 13%, 37% and 50%, respectively. Conclusions EGFR may play important action in the lung cancer prognosis.