肺炎型肺腺癌患者EGFR基因突变和ALK基因重排情况的临床分析

Clinical analysis on EGFR gene mutation and ALK gene rearrangement in patients with pneumonia-type lung adenocarcinoma

目的探讨肺炎型肺腺癌患者EGFR基因突变、ALK基因重排的特点及其临床意义。方法选取2016年1-8月第三军医大学新桥医院病理组织学确诊为肺腺癌患者154例为研究对象,根据影像学表现分为肺炎型(30例)、非肺炎型(124例)。154例患者均进行EGFR基因检测,其中87例患者同时进行ALK基因重排检测。比较肺炎型与非肺炎型肺腺癌患者EGFR基因突变率、ALK基因重排率及临床特征的关系。结果肺炎型组患者EGFR基因突变率为20.0%(6/30),非肺炎型组为47.6%(59/124),差异有统计学意义(P<0.05)。两组年龄、吸烟史、性别、肿瘤家族史、ALK基因重排、TNM分期比较,差异无统计学意义(P>0.05)。总体EGFR基因突变率为42.2%(65/154),吸烟史、性别与EGFR基因突变有关,年龄、肿瘤家族史与EGFR基因突变无明显相关性。总体ALK基因重排率为11.5%,吸烟史、肿瘤家族史、性别、年龄与ALK基因重排无明显相关性。87例同时行EGFR及ALK基因检测的患者,未发现EGFR基因突变、ALK基因重排共同存在的情况。结论影像学表现为肺炎型的肺腺癌患者,应同时行EGFR基因突变和ALK基因重排检测,以便为晚期肿瘤患者制定全面的全程管理方案。

Objective To investigate the characteristics and clinical significance of epidermal growth factor receptor（EGFR） gene mutation and anaplastic lymphoma kinase（ALK） gene rearrangement in the patients with pneumonia-type lung adenocarcino- ma. Methods A total of 154 cases of lung adenocarcinoma definitely diagnosed by histopathology in Xinqiao Hospital from January to August 2016 served as the research subjects and divided into pneumonia-type tung carcino.ma（PTLC,30 cases） and non-pneumo- nia-type lung carcinoma（non-PTLC, 124 cases） according to the imaging manifestations. The EGFR gene detection was performed in 154 cases,among them 87 cases simultaneously conducted the ALK gene rearrangement detection. The EGFR mutation rate and ALK gene rearrangement rate were compared between PTLC and non-PTLC,and their clinical characteristics differences were investigated. Results - The mutation rate of EGFR, which PTLC occurred less frequently than non-PTLC in lung adenocarcinoma （20.0 % vs. 47.6 % P〈0. 05）. The age, smoking history, sex, tumor family history,ALK gene rearrangement and TNM stage had no statistical differences between the two groups（P〉0. 05）. The total mutation rate of EGFR gene was 42. 2% （65/154）. The smoking history and sex were related with the EGFR gene mutation, while the age and tumor family history had no obvious relation with EGFR gene mutation. The total ALK gene rearrangement rate was 11.5 %. The smoking history, tumor family history,sex and age had no obvious relation with the ALK gene rearrangement. Among 87 cases of EGFR and ALK simultaneous gene detection, the co-existence of EGFR gene mutation and ALK rearrangement was not found. Conclusion Imaging ,findlings of patients with PTLC, it should be conducted to detection that EGFR gene mutation and ALK gene rearrangenment, in order to formulate comprehensive management scheme in the patients with advanced tumor.