EGFR基因突变与非小细胞肺癌临床病理特征的关系

Relationship between EGFR Gene Mutation and Clinical Pathological Features of Non-small Cell Lung Cancer

目的研究临床病理特征及相关实验室检测指标与非小细胞肺癌患者外科手术治疗预后的关系。方法手术切除的非小细胞肺癌患者标本一共190例,采用实时荧光PCR法,检测EGFR基因第18、19、20和21号外显子的突变情况。分析EGFR基因突变与其临床病理关系、EGFR基因突变丰度和临床特征的关系。结果 EGFR基因突变的影响因素包括:性别、吸烟史、病理分型,高危因素包括:女性、吸烟者、腺癌。190例NSCLC患者肿瘤组织中,成功检测出90例存在EGFR基因突变,EGFR突变丰度与性别(P=0.962)、吸烟史(P=0.809)无相关性;EGFR突变丰度与病理分型相关。和非腺癌对比,腺癌患者EGFR基因突变丰度明显更高,(χ~2=14.110,P=0.000)。术前腺癌血清VEGF水平明显低于非腺癌组,P<0.05;术后腺癌血清CD44v6明显高于非腺癌患者,P<0.05;术后Ⅲ~Ⅳ期组血清VEGF、CD44v6水平明显高于Ⅰ~Ⅱ期患者,P<0.05。结论非小细胞肺癌EGFR基因突变的高危因素为吸烟者、女性、腺癌,与年龄、性别、肿瘤分期、吸烟史无明显相关性。

Objective To study the relationship between EGFR gene mutation and clinical pathological features of non- small cell lung cancer. Methods 190 cases of non-small cell lung cancer specimens treated with surgical resection used real- time fluorescent PCR method ,to detect EGFR gene mutation in exon 21 and 18,19,20 sub. Relationship between EGFR gene mu- tation and clinical pathological characteristics and abundance of mutations in the EGFR gene were analyzed. Results The influ- ence factors of EGFR mutations ： gender, smoking history, disease Physical type, risk factors include ： women, smokers, adenocarci- noma. In tumor tissues of 190 NSCLC patients ,90 cases were successfully detected EGFR gene mutation, EGFR mutation abun- dance and gender（ P = O. 962）, smoking history（ P = 0. 809 ） had no significant difference; EGFR mutation type differences in a- bundance and pathology statistical significance. Compared with non adenocarcinoma, gland cancer patients with EGFR gene muta- tion abundance was significantly higher（ X2 = 14.110, P = 0. 000 ）. Preoperative adenocarcinoma serum VEGF was significantly lower than non adenocarcinoma group,P 〈 0.05 ;postoperative cancer serum CD44v6 was significantly higher than non adenocarci- noma group,P 〈0.05 Ⅲ- Ⅳ group;serum VEGF after operation,CD44v6 was significantly higher than that of Ⅰ-Ⅱ group,P 〈 0.05. Conclusion The risk factors of EGFR gene mutation in non-small cell lung cancer in smokers, female, adenocareinoma, and age, sex, tumor staging, smoking history obvious correlation.