HRM方法检测非小细胞肺癌患者胸水标本癌细胞基因突变的临床意义

Feasibility of HRM to detect gene mutations in hydrothorax of patients with non-small cell lung cancer

[目的]探讨应用HRM方法检测非小细胞肺癌患者胸水标本癌细胞EGFR、KRAS基因突变用于指导EGFR酪氨酸激酶受体抑制剂治疗的可行性。[方法]收集36例非小细胞肺癌患者胸水标本,常规提取DNA,HRM方法检测KRAS基因第2外显子、EGFR基因第19和21外显子突变。统计分析胸水标本与前期检测过的非小细胞肺癌组织KRAS、EGFR突变率差异。[结果]胸水标本36例中,2例(5.6%)KRAS突变,10例(27.8%)EGFR突变(其中EGFR第19和21外显子突变各5例)。前期检测过的非小细胞肺癌组织KRAS和EGFR突变率分别为5.8%和36.3%。KRAS和EGFR突变率在胸水标本与前期非小细胞肺癌组织中差异均无显著性意义(P>0.05)。[结论]对难以获得肺癌组织标本的非小细胞肺癌患者可应用HRM方法检测胸水标本筛查KRAS、EGFR基因突变,指导EGFR酪氨酸激酶受体抑制剂应用。

[Objective] To explore the clinical significance of HRM to detect EGFR and KRAS gene mutations in hydrothorax of patients with non-small cell lung cancer（NSCLC） for directing EGFR tyrosine kinase inhibitor therapy.[Methods] The mutations of KRAS gene in exon 2 and EGFR gene in exon 19,21 were detected with HRM.The frequencies of EGFR and KRAS mutations between hydrothorax samples and cancer tissue samples from patients with NSCLC were analyzed statistically.[Results] There were 2 cases（5.6%） with KRAS mutations and 10 cases（27.8%） with EGFR mutations,including 4 cases in exon 19 and 5 cases in exon 21 found in hydrothorax with HRM.The frequencies of KRAS and EGFR mutation,detected in NSCLC tissues before,were 5.8% and 36.3% separately.There was no significant difference in either KRAS or EGFR between hydrothorax and cancer tissue samples.[Conclusion] It is helpful to patients with NSCLC who have lost the operation opportunity to detect the gene mutation in hydrothorax with HRM in directing the EGFR tyrosine kinase inhibitor therapy.