表皮生长因子受体基因在非小细胞肺癌原发灶与淋巴结转移灶中的突变情况分析及临床意义

Analysis of mutations situation and clinical significance of epidermal growth factor receptor gene in primary focus and metastatic focus of non-small cell lung cancer

目的探讨表皮生长因子受体(EGFR)基因在非小细胞肺癌(NSCLC)原发灶及淋巴结转移灶中的突变情况,分析其在不同病灶中的突变率与临床病理特征的关系。方法采用实时荧光聚合酶链反应(RT-PCR)的Taq Man探针法检测50例NSCLC原发灶及淋巴结转移灶中EGFR基因突变情况,并通过统计软件分析其与临床病理特征的相关性。结果 50例NSCLC原发灶中,EGFR基因突变率为38.0%(19/50),与性别、病理组织学类型、吸烟关系密切(P<0.05),与年龄、分化程度、部位、民族、临床分期无关(P>0.05);在淋巴结转移灶中的突变率为22.0%(11/50),与原发灶EGFR基因突变率比较差异有统计学意义(P<0.05),而与其他临床病理特征无关(P>0.05)。结论 EGFR基因突变主要集中于女性、肺腺癌、非吸烟患者,并且在NSCLC原发灶及淋巴结转移灶中突变不一致,表现出肿瘤的异质性,影响疗效。

Objective To investigate the mutations situation of epidermal growth factor receptor （EGFR） gene in primary focus and metastatic focus of non-small cell lung cancer （NSCLC）, and to analyze the relationship of the mutation rate of it in different focus and clinicopathologic feature. Methods The TaqMan probe method of real-time polymerase chain reaction （RT-PCR） was used to detect the conditions of EGFR gene mutation in primary focus and metastatic focus of 50 cases with NSCLC, and its correlation with clinicopathologic feature was analyzed through statistical software. Results Among the primary focus of 50 cases with NSCLC, the gene mutation rate of EGFR was 38.0% （19/50）, which was closely correlated with gender, histopathological type, smoking （P〈 0.05）, which had no correlations with age, differentiated degree, postion, nation, clinical stages （P 〉 0.05）; the mutation rate in metastatic focus was 22.0% （11/50）, which had a statistically significant difference compared with gene mutation rate of EGFR in primary focus （P 〈 0.05）, while it had no correlations with other clinicopathologic features （P 〉 0.05）. Conclusion The gene mutation of EGFR was mainly concentrated on female, pulmonary adenocarcinoma, non-smoking patients, and shows different mutation in primary focus and metastatic focus of NSCLC, put up the heterogeneity of tumor, which affects the curative effect.