晚期非小细胞肺癌组织与血浆EGFR基因表达差异及临床意义

Differential Expression and Clinical Significance of EGFR gene in Tissue and Plasma in Advanced Non-SmallCell Lung Cancer

目的]探讨DNA表皮因子生长受体（epidermal growth factor receptor，EGFR）基因在晚期非小细胞肺癌（no-small cell lungcancer，NSCLC）患者组织和血浆中的表达差异及临床意义。[方法]选取2015年3～6月在本院初诊的NSCLC患者65例，提取血浆及组织标本DNA，检测DNAEGFR基因突变情况并比较。[结果]65例患者组织EGFR基因突变检出23例，突变率为35．4％，循环DNA中检出12例，突变率为18．5％。以组织标本检测为准，血浆DNA中EGFR基因突变检测的特异性为93．8％；灵敏度为43．5％。在组织标本检测中，44例男性EGFR基因突变率为22．7％；21例女性患者EGFR基因突变率为61．9％，两者比较有统计学差异（P〈0．05）。41例吸烟患者EGFR基因突变率为17．1％（7／41）；24例不吸烟患者EGFR突变率为66．7％（16／24），两者比较有统计学差异（P〈0．05）。41例腺癌患者EGFR突变率为46．3％；24例非腺癌患者EGFR突变率为16．7％，两者比较有统计学差异（P〈0．05）。血浆中EGFR基因突变的分布与肿瘤组织检测结果相符，在不同性别、不同吸烟情况及不同病理类型中差异有统计学意义（P〈0．05），在肿瘤分期方面无显著性差异（P〉0．05）。[结论]对于晚期NSCLC患者，血浆循环DNAEGFR基因突变检测特异性高、敏感性低，可用于其补充诊断。

Objective To investigate the expression and clinical significance of epidermal growth factor receptor （EGFR） gene （DNA） in tissue and plasma of patients with advanced non-small cell lung cancer （NSCLC）.[Methods]Sixty-five cases of NSCLC in our hospital from March to June 2015 were selected, and the plasma and tissue samples were extracted, EGFR DNA gene mutation were detected and compared.[Results]EGFR gene mutations were detected in 23 cases out of 65 patients, and the mutation rate was 35.4 % ;12 cases were detected in circulating DNA, the mutation rate was 18.5 %. The specificity of EG- FR gene mutation detection of the plasma DNA was 93.8% the sensitivity was 43.5 %. The mutation rate of EGFR gene was 22.7 % in 44 male patients in the tissue samples~ the mutation rate of EGFR gene in 21 female patients was 61.9 %, the differ- ence was statistically significant （ P 〈0.05）. The mutation rate of EGFR gene was 17.1% （7/41） in 41 patients with smoking EGFR mutation rate was 66.7% （16/24） in 24 patients without smoking, and there was a significant difference between the two groups （ P〈0.05）. The mutation rate of EGFR was 46.3% in 41 cases of adenocarcinoma and the EGFR mutation rate of 24 cases of non adenocarcinoma patients was 16.7%, the difference was statistically significant （ P 〈0.05）.The distribution of EGFR gene mutations in plasma was consistent with the results of tumor tissue detection. There were statistically significant differences in different gender, smoking status and different pathological types （ P 〈0.05）. There was no significant difference in tumor stage （ P〉0.05）.[Conclusion] For patients with advanced NSCLC, detection of EGFR DNA gene mutation in plas- ma circulation has high specificity and low sensitivity, which can be used in the supplementary diagnosis.