中晚期非小细胞肺癌骨转移与EGFR基因突变相关分析

Correlative analysis of bone metastasis and EGFR mutation in the moderate non small cell lung cancer

目的:探讨中晚期非小细胞肺癌患者骨转移及表皮生长因子受体(EGFR)基因突变相关性。方法:选取经病理证实且明确EGFR基因有无突变的101例中晚期非小细胞肺癌患者,以99 mTc-MDP全身骨扫描为主要依据判定患者骨转移结果及分级,采用组间卡方检验及Spearman相关分析评价EGFR基因突变对中晚期非小细胞肺癌患者骨转移发生及发展的预示意义。结果:中晚期非小细胞肺癌骨转移患者中阳性病灶分别为胸部(36.72%)、脊柱(36.26%)、骨盆(15.94%)、四肢(6.93%)及头颅(4.15%);EGFR突变率腺癌患者明显高于非腺癌患者(P<0.05),EGFR野生组与突变组间骨转移发生、病灶分布及发展无明显差异及相关性(χ~2=0.745,P>0.05;r=0.114,P>0.05)。结论:中晚期非小细胞肺癌骨转移患者以中轴骨多发转移为主,EGFR基因突变对骨转移的发生倾向及发展的严重程度没有明确预示作用。

Objective： To discuss the clinic characteristic of bone metastasis and EGFR mutation in the moderate non small cell lung cancer and try to analyze the correlation between them. Methods： 101 cases with non small cell lung cancer confirmed by pathology were examined with 99 m Tc-MDP bone scintigraphy and EGFR gene detection.Chi-square analysis,and spearman correlation analysis were used to evaluate the EGFR mutation in predicting the development of the skeletal metastasis. Results： The skeletal metastasis occurred in： chest（ 36. 72%）,spine（ 36. 26%）,pelvis（ 15. 94%）,four limbs（ 6. 93%）,skull（ 4. 15%）. EGFR mutation rate in adenocarcinoma was obviously higher than that of no adenocarcinoma patients（ P〈0. 05）. There was no obvious difference in the occurrence and development of the skeletal metastasis between the EGFR wild group and the mutation group（ χ~2=0. 745,P〈0. 05,r = 0. 132,P〈0. 05）. Conclusion： Bone metastasis of non small cell lung cancer is mostly seen in axial skeleton（ chest and spine）. The EGFR mutation for non small cell lung cancer has no significance in predicting the occurrence and development of bone metastasis.