非小细胞肺癌患者外周血与组织中K-ras基因突变的研究

Study on K-ras gene mutation in peripheral blood and tumor tissue of non small cell lung cancer patients

目的检测非小细胞肺癌患者外周血与肿瘤组织K-ras基因突变率及两者的一致性,探讨外周血K-ras基因突变的临床应用价值。方法应用实时荧光定量PCR方法检测257例非小细胞肺癌组织,318例非小细胞肺癌外周血,其中185例外周血标本和组织标本配对,检测其中K-ras基因突变,比较外周血和组织标本突变一致性,分析K-ras基因突变和患者临床特征相关性。结果外周血标本中检测出37例突变(11.64%),组织标本中29例突变(11.28%),两种标本一致性为76.19%,差异有统计学意义(Kappa=0.671,P=0.000)。结论非小细胞肺癌患者外周血与组织K-ras基因突变一致性较高,在无法获得组织学标本时可以检测外周血K-ras基因状态,为非小细胞肺癌的临床诊疗提供帮助。

Objective To detect the consistency of the K-ras gene mutation in peripheral blood and tumor tissue of patients with non small cell lung cancer and discuss the clinical application value of K-ras gene mutation in pei＇ipheral blood. Method Real-time fluorescent quantitative PCR was used to test the tissues in 257 patients of non small cell lung cancers and the peripheral blood samples in 318 patients Of non small cell lung cancer, of which 185 cases of pe- ripheral blood specimens could match the tissue samples, anddetected the K-ras gene mutation in them by compari- son of mutations consistency in blood and tissue samples, and analyzed the correlation between K-ras gene mutations and clinical characteristics of patients. Result The K-ras gene mutation rate was 11.64 ~ in peripheral blood of 37 pa- tients with non small cell lung cancer,and was 11.28% in 29 cancer tissues, the mutation consistency was 76. 19% in peripheral blood-tumor tissue matched samples. There were statistical signifieant!y differences. （Kappa=0. 671, P=0. 000）. Conclusion The consistency of the K-ras gene mutation in peripheral blood and tissue is high. ,K-ras gene mutations of peripheral blood could be used for clinical diagnosis and treatment in cases when tissue specimen is hard to get.