晚期肺腺癌患者13例治疗前后EGFR基因突变检测结果比较

Comparison of EGFR mutation status in 13 matched pretreatment and post-treatment samples from patients with advanced lung adenocarcinoma

目的分析晚期肺腺癌患者治疗前后表皮生长因子受体(epidermal growth factor receptor,EGFR)基因的突变状态。方法收集13例晚期肺腺癌患者治疗前后的病理标本,采用扩增阻滞突变系统(amplification refractory mutation system,ARMS)法检测EGFR基因突变状态。结果治疗前EGFR突变阳性10例,经EGFR-TKI或常规化疗2个月～17个月后EGFR突变阳性9例。在治疗前EGFR突变阳性的10例中,治疗前、后突变类型一致4例,不一致6例。在突变类型不一致的6例中,3例治疗前为单突变,而治疗后为双突变;1例治疗前为T790M突变,而治疗后变为阴性;另有2例治疗前分别为19DEL、L861Q突变,而治疗后分别为L858R、19DEL突变。结论晚期肺腺癌患者治疗后EGFR基因突变类型可发生改变,治疗前后突变状态不一致率约为60%。

Objective To analyze the epidermal growth factor receptor(EGFR)gene mutation status in matched pretreatment and post-treatment samples from patients with advanced lung adenocarcinoma.Methods The EGFR gene mutation status was detected in 13 matched pretreatment and post-treatment samples from patients with advanced lung adenocarcinoma by amplification refractory mutation system (ARMS).Results EGFR mutations were detected in 10 pretreatment patients,and 9 patients were positive for EGFR mutations after 2 to 17 months of EGFR-TKI or conventional chemotherapy. Among the 10 pretreatment patients positive for EGFR mutations,4 cases showed consistent mutations,and 6 cases showed inconsistent mutations after treatment.Among the 6 cases with inconsistent mutation types,3 cases showed single mutations before treatment,and double mutations after treatment. One case showed T790M mutation before treatment,and became negative for EGFR mutation after treatment. Two cases showed 19DEL and L861Q before treatment,respectively,and after treatment,were positive for L858R and 19DEL mutations,respectively. Conclusion The type of EGFR gene mutation can be changed in patients with advanced lung adenocarcinoma after treatment. The inconsistent rate of mutation status before and after treatment is about 60%.