不同病理类型肺腺癌患者EGFR基因突变特点分析

Study on Characteristics of EGFR Gene Mutation in Patients with Different Pathological Types of Lung Adenocarcinoma

[目的]探讨不同病理类型肺腺癌患者表皮生长因子受体(EGFR)基因突变的特点。[方法]统计286例肺腺癌患者的临床资料和基础信息(性别、年龄、民族、吸姻史、饮酒史、家族史、合并疾病等、血型.肿瘤部位、临床分期、分化程度、淋巴结转移)。检测其EGFR基因突变情况,探讨不同病理类型肺腺癌患者EGFR基因突变特点。[结果]286例肺腺癌患中EGFR基因突变患者152例,以E19及E21突变为主,占比分别为40.79%、39.47%。EGFR基因阳性女性、汉族、无吸烟史、临床分期Ⅲ或Ⅳ期、高分化悲者明显明显高于男性、少数民族,有吸烟史、临床分期Ⅰ或Ⅱ期、低分化患者比例(P<0.05)。新分类中不同病理类型患者EGFR基因阳性对比存在显著差异(P<0.05);半定量综合分型中EGFR基因阳性病理类型不以贴壁为主,不以腺泡为主、含乳头、含变异.患者明显多于EGFE阴性患者(P<0.05);WHO病理类型中EGFR阳性、阴性比例相比较差异无显著性(P>0.05)。[结论]肺腺癌EGFR基因突变多发于女性、汉族、无吸烟史、临床分期川或IV期、高分化患者,且在肺腺癌新分类标准中不同病理类型患者EGFR基因突变的发生率均存在差异。

[Objective]To investigate the characteristics of epidermal growth factor receptor(EGFR)gene mutation in patients with different pathological types of lung adenocareinoma.[Methods]A total of 286 patients with lung adenocarcinoma were retrospectively analyzed.Basic information of patients(gender.age.nationality,smoking history,drinking history.family history,blood lype.turmor location.clinical stage.degree of differenti-ation.lymph node metastasis)were counted and compared.The mutants of EGFR gene were detected to show the characleristics of EGFR gene mutation in patients with different pathological types.[Results]Test results showed that among 286 cases of lung adenocarcinoma.152 patients had EGFR gene mutation mainly with E19 and E21 mutations.accounting for 40.79%and 39.47%.respectively.The proportion of EGFR gene-positive women.Han nationality,no smoking history,clinical stage Ⅲ or Ⅳ,and well-differeniated patients was significantly higher than that of men.ethnie minoritics.smoking history,clinical stage Ⅰ or Ⅱ,and poorly differentiated patients(P<0.05).There were significant differences in EGFR gene positivity among patients with different pathological types in the new classification(P<0.05).In semi-quantitative comprehensive classification.the positive patholog-ical types of EGFR gene were not mainly adherent and acinar-bused,instead nipple and variant containing types were significantly more than EGFR negative patients(P<0.05).There was no signilicant difference in the pro-portion of positive and negative EGFR in WHO pathological types(P>0.05).[Conclusion]The mutation of EG-FR gene in lung adenocarcinoma is more common in women,Han nationality,non-smoking history,clinical stage Ⅲ or Ⅳ,highly differentiated patients.and there are differences in the ineidence of EGFR gene mutations in pa-tients with different pathological types in the new classification criteria of lung adenocarcinoma.