肺腺癌新分类各亚型与EGFR突变的相关性

The corrleation between the new lung adenocarcinoma classification and the EGFR mutation

目的:探讨肺腺癌新分类[2011年国际肺癌研究会(IASLC)/美国胸科协会(ATS)/欧洲呼吸协会(ERS)肺癌多学科协作组更新的非小细胞肺腺癌的分型标准]各亚型与表皮生长因子受体(EGFR)突变之间的关系。方法:共纳入240例手术切除的非小细胞肺腺癌患者。采用ARMS法对所有手术标本行EGFR突变检测。卡方分析比较不同病理亚型与患者EGFR突变发生率的关系。结果:纳入EGFR突变检测的240例患者中,大部分属于腺泡状(占89%)和乳头状(占56%)肺腺癌类型。EGFR在腺泡状、贴壁状、乳头状以及微乳头为主腺癌亚型的发生率高于非该亚型的肺腺癌(P<0.05);实性为主腺癌亚型EGFR突变发生率低于非实性为主腺癌亚型(P<0.05)。结论:不同的腺癌病理亚型EGFR突变发生率存在差异,其中腺泡状为主亚型、微乳头为主亚型、乳头状为主亚型和贴壁状为主亚型的突变发生率较高,实性为主腺癌亚型突变发生率较低。

Objective： To evaluate the correlation of EGFR mutation and histological subtypes of lung adenocarcinomabased on the IASLC/ATS/ERS classification 2011. Methods： 240 resected lung adenocarcinomaspecimens were analyzed by ARMS, then the differences between histological subtypes and EGFR mutationwere compared by the x2 test. Results： EGFR mutation was detected in 240 specmens, most of which were acinarand papillary predominant adenocarcinoma, 89% and 56% respectively. EGFR mutation rate of the specimenswith acinar, lepidic, papillary, or micropapillary component was higher than that of without these components（P〈0.05）, and with solid or mucinous component was lower than that without the component （P〈0.05）. Conclusion：There is heterogeneity of EGFR mutation in lung adenocarcinoma. The presence of well-differentiatedcomponents in lung adenocarcinoma, such as acinar, micropapillary, papillary and lepidic, indicates a higherEGFR mutation rate, while the solid and mucinous component indicates a lower EGFR mutation rate.