胸水细胞块EGFR基因突变检测在非小细胞肺癌中的临床意义

Clinical significance of EGFR gene mutation in pleural effusion cell blocks in non-small cell lung cancer

目的探讨应用实时荧光定量PCR方法检测非小细胞肺癌阳性胸水细胞块EGFR突变的临床意义。方法收集具有组织标本作为对照的非小细胞肺癌阳性胸水60例,制作细胞块,提取DNA,应用实时荧光定量PCR法同时对细胞块和组织标本的EGFR第19外显子(19-Del)和21外显子(L858R)突变进行检测,分析细胞块与组织标本的EGFR突变率的差异。结果胸水细胞块中EGFR突变率为35%(21/60),其中19-Del突变11例,L858R突变9例,19-Del和L858R双突变1例;组织标本中EGFR突变率为36.7%(22/60),其中19-Del突变12例,L858R突变9例,19-Del和L858R双突变1例。两种标本的EGFR突变率差异无统计学意义(P>0.05);胸水细胞块EGFR突变类型与其对应的组织标本相一致。结论胸水细胞块与组织样本在EGFR基因突变上具有较高的一致性。

Objective To explore the clinical significance of EGFR mutations in positive pleural effusion cell block of non-small cell lung cancer by RT-PCR. Methods Sixty cases of biopsy tissue specimens and pleural effusion from non-small cell lung cancer patients were collected. Cell blocks of pleural effusion specimens were made. DNA was extracted to detect EGFR mutation in exon 19（19-Del） and exon 21（ L858R） in biopsy tissue specimens and pleural effusion by RT-PCR. The mutation rate of EGFR was analyzed between pleural effusion and biopsy tissue specimens. Results The mutation rate of EGFR in pleural effusions was 35%（21/60）,including 11 cases of 19-Del mutation,9 cases of L858 R mutation,and 1 case of 19-Del and L858 R double mutations. The mutation rate of EGFR in biopsy tissue specimens was 36. 7%（22/60）,including 12 cases of 19-Del mutation,9 cases of L858 R mutation,and 1case of 19-Del and L858 R double mutations. The rates of EGFR mutation was not significantly different between the two types of specimens（ P 〉 0. 05）. The EGFR mutation types in pleural effusion were the same as that of the tissue specimen. Conclusion Pleural effusion cell block and biopsy tissue specimen show high consistency in EGFR mutation.