肺癌患者表皮生长因子受体基因突变与脂类代谢的相关性

Correlations between gene mutation of epidermal growth factor receptor and lipid metabolism in lung cancer

目的观察肺癌患者表皮生长因子受体（EGFR）基因突变与脂类代谢的相关性，探索可预测EGFR基因突变的相关因素。方法纳入2011年6月至2015年2月107例肺癌患者，应用EliVision Plus免疫组织化学法测定肺癌组织中EGFR蛋白表达的情况，利用ARMS-实时荧光定量PCR法检测肺癌组织中EGFR基因突变，分为突变组和无突变组，比较2组患者一般资料及外周血总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1、载脂蛋白B水平差异，分析EGFR基因突变与上述指标的相关性。结果107例患者中，突变65例，无突变42例。突变组三酰甘油水平、体重指数高于无突变组，差异有统计学意义［（1.6±1.0）mmol/L比（1.0±0.5）mmol/L、（22.7±2.6）kg/m^2比（20.8±3.7）kg/m^2］（P〈0.05）。2组患者血清总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1、载脂蛋白B水平差异无统计学意义（P〉0.05）。女性肺癌患者EGFR基因突变率高于男性，差异有统计学意义［（65.2%（15/23）比32.1%（27/84），χ^2=8.722，P〈0.05］。无吸烟史患者EGFR基因突变率高于吸烟患者，差异有统计学意义［52.8%（28/53）比25.9%（14/54），χ^2=8.120，P〈0.05］。腺癌EGFR基因突变率高于鳞癌，差异有统计学意义［53.7%（36/67）比10.3%（3/29），χ^2=15.795，P〈0.05］。Logistic分析结果示三酰甘油、组织学类型为EGFR基因突变的预测因素（P〈0.05）。结论肺癌EGFR基因突变患者存在脂类代谢异常，高三酰甘油、组织学类型可能为EGFR基因突变的预测因素。

ObjectiveTo investigate the correlations between gene mutation of epidermal growth factor receptor （EGFR） and lipid metabolism in lung cancer, and to explore the related factors that may predict EGFR gene mutations. MethodsA total of 107 patients with lung cancer from June 2011 to February 2015 were enrolled. The EGFR protein levels were tested by EliVision Plus immunohistochemistry, then the gene mutation was measured by ARMS-Real-Time PCR. According to the mutation result, the patients were divided into mutation group and non-mutation group. The general data and the levels of total cholesterol, triacylglycerol, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C）, apolipoprotein A1 and apolipoprotein B were compared between the two groups. The correlations between above indices with EGFR mutation were analyzed. ResultsThere were 65 cases in mutation group and 42 cases in non-mutation group. The levels of triglyceride and body mass index in mutation group were significantly higher than those in non-mutation group [（1.6±1.0） mmol/L vs （1.0±0.5） mmol/L, （22.7±2.6） kg/m^2 vs （20.8±3.7） kg/m^2, P〈0.05]. While the levels of total cholesterol, HDL-C, LDL-C, apolipoprotein A1, apolipoprotein B were no statistically different between the two groups （P〉0.05）. The mutation rate of EGFR gene was significantly higher in female patients than that in male patients [（65.2% （15/23） vs 32.1% （27/84）, χ^2=8.722, P〈0.05], was significantly higher in non-smokers than that in smokers [52.8% （28/53） vs 25.9% （14/54）, χ^2=8.120, P〈0.05], was significantly higher in adenocarcinoma than that in squamous cell carcinoma [53.7% （36/67） vs 10.3% （3/29）, χ^2=15.795, P〈0.05]. Logistic regression analysis result showed that the triglycerides and histological type were predictors of EGFR mutations （P〈0.05）. ConclusionsIn lung cancer patients, EGFR mutation may be involved in abnormal lipid metabolism. Increased triglyceride and histological type might be one of predictors of EGFR mutations.