小肠腺癌组织中表皮生长因子受体的基因状态及其意义

The expression of epidermal growth factor receptor gene in small intestinal cancer tissue and its significance

目的 检测小肠腺癌组织中表皮生长因子受体（EGFR）基因扩增以及突变.方法 应用EGFR突变型抗体（针对EGFR 19位外显子E746-A750缺失以及21位外显子L858R点突变）,采用免疫组织化学方法检测53例小肠腺癌组织芯片以及24例手术切除的小肠腺癌组织中EGFR突变以及总EGFR表达,并采用基因测序的方法检测24例手术切除标本中EGFR基因突变.结果 77例小肠腺癌标本EGFR 19位外显子E746-A750缺失率为9.1％,21位外显子L858R突变率为6.5％,总的EGFR阳性表达率为45.5％.77例小肠腺癌标本中EGFR阳性表达率、EGFR 19位外显子E746-A750缺失及21位外显子L858R点突变阳性率与患者年龄、性别、肿瘤分化程度以及分级、分期无明显相关（P＞0.05）.结论 小肠腺癌组织内EGFR发生基因突变的概率较小,大部分的小肠腺癌不适合应用EGFR-酪氨酸激酶抑制剂进行治疗.

Objective To study the expression of epidermal growth factor receptor （EGFR） in small intestine adenocarcinoma （SIA） samples.Methods Through immunohistochemical method and gene sequencing,total expression of EGFR and EGFR mutations were detected in 53 cases of small intestinal carcinoma tissue microarray and 24 cases of surgically resected small intestinal cancer tissues by using EGFR mutation type antibodies （for EGFR 19 exons E746-A750 missing and 21 exon L858R point mutations）.Results The EGFR 19 exons E746-A750 loss rate was 9.1%,21 exon L858R mutation rate was 6.5% and the total EGFR positive expression rate was 45.5% respectively in 77 cases of small intestinal carcinoma specimens.There was no significant correlation among EGFR positive expression rate of EGFR 19 exons,E746-A750 missing,21 exon L858R point mutation positive rate with age,sex,tumor differentiation and classification in specimens of 77 cases of small intestinal carcinoma （P 〉 0.05）.Conclusion EGFR gene mutation was a minor event in small intestinal carcinoma tissues and mnost ofthe small intestinal carcinomas are not suitable for application of EGFR tyrosine kinase inhibitor treatment.