超声引导下粗针活检对非小细胞肺癌EGFR基因突变检测的应用价值

The clinical value of ultrasound guided coarse needle biopsy for the detection of EGFR gene mutations in NSCLC

目的：探讨超声引导下粗针活检对非小细胞肺癌（NSCLC）EGFR基因突变检测的诊断价值。方法：24例临床诊断为Ⅱ-Ⅳ期的非小细胞肺癌患者,采用美国Bard自动活检枪及14-18G活检针经超声引导下行肿块穿刺,穿刺标本行病理学检测及PCR法EGFR基因突变分析。结果：6例采用14G针,17例采用16G针,1例采用18G针,取材满意率为100%,所有病例穿刺活检后无严重并发症。病理诊断结果：腺癌17例,鳞癌4例,腺鳞癌2例,肉瘤样癌1例。EGFR基因突变11例,其中5例外显子19突变,4例外显子21突变,1例外显子20突变,1例外显子20、21均突变。结论：超声引导下粗针活检可作为晚期非小细胞肺癌EGFR基因检测的取材手段,可为临床药物分子靶向治疗提供依据。

Objective： To investigate the value of ultrasound guided coarse needle biopsy specimens in assessing EGFR gene mutation in advanced non- small cell lung cancer（ NSCLC）. Methods： All 24 patients with stage Ⅱ- Ⅳlung cancer,underwent ultrasound guided coarse needle biopsy with 14 -18 G biopsy needle. The specimens were detected for histology diagnosis and EGFR mutation analysis. Results： Ultrasound guided coarse needle biopsy was successfully performed in 6 patients using 14 G needle,17 patients with 16 G needle and 1 patient with 18 G needle. Histology diagnosed 17 adenocarcinoma,4 squamous cell carcinoma,2 adenosquamous carcinoma and 1 sarcoma. EGFR gene mutation in 11 cases： 5 cases of exon 19 mutation,4 cases of exon 21 mutation,1 case of exon 20 mutation,1case of exon 20 and 21 were all mutated. Conclusion： Ultrasound guided coarse needle biopsy can be used to obtain lung tumor tissue for EGFR gene mutation analysis in patients with advanced NSCLC. It can provide the basis for clinical drug molecular targeted therapy.