表皮生长因子受体(EGFR)基因突变与肺恶性局灶性磨玻璃病变的关系

Relationship between the epidermal growth factor receptor gene mutation and malignant pulmonary focal ground-glass lesion

目的探讨表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变与表现为局灶性磨玻璃病变(f GGL)的肺恶性肿瘤的关系。方法回顾性分析2012年8月至2015年2月长征医院胸心外科行手术治疗的肺恶性f GGL 86例患者的临床资料,其中男26例、女60例,年龄(56.14±10.55)岁,分析其EGFR基因突变结果与各临床因素的关系。结果术后病理结果示不典型腺瘤样增生伴局灶原位癌或原位癌10例,微浸润性腺癌15例,腺癌61例;EGFR基因突变43例,其中19号外显子19-del突变14例,21号外显子L858R突变27例,21号外显子L861Q突变2例。EGFR基因突变与性别、肿瘤直径、病理类型、病理分期、肿瘤有无实性成分、胸膜有无侵犯、病灶个数等临床因素均无显著相关(P>0.05),高龄、不吸烟患者EGFR基因突变率高于低龄及吸烟患者,差异具有统计学意义(P<0.05)。随访日期截至2015年6月30日,入组患者全部存活,随访时间(440.48±186.61)d。结论 EGFR基因在肺恶性f GGL患者中有较高的突变率,为肺恶性f GGL的基础研究和临床治疗提供重要参考。

Objective To analyze the relationship between the epidermal growth factor receptor（EGFR） gene mutation and malignant pulmonary focal ground-glass lesion （fGGL）. Methods We retrospectively collected the clinical data of 86 patients with surgical treatment in the department of cardiothoracic surgery of Changzheng Hospital from August 2012 to February 2015. There were 26 males and 60 females with a mean age of 56.14±10.55 years. We analyzed the relationship between the EGFR gene mutation and the related clinical data. Results Postoperative pathology showed atypical adenomatous hyperplasia （AAH） combined with focal adenocarcinoma in situ （AIS） or AIS in 10 patients, minimally invasive adenocarcinoma （MIA） in 15, and lepidic predominant adenocarcinoma （LPA） in 61. The EGFR gene mutation reports showed the exon 19 19-del mutation in 14 patients, exon 21 L858R mutation in 27, and exon 21 L861Q mutation in 2. There was no difference between the mutation of EGFR gene and clinical factors except age and smoking （P〉0.05）. Till June 30, 2015, all patients were alive and follow-up was 440.48±186.61 days. Conclusion The EGFR gene in patients with malignant pulmonary fGGL shows a higher mutation rate, which provides important clinical reference data for the basic research and the clinical treatment.