胸水细胞蜡块与“新鲜”胸水在肺腺癌EGFR基因检测中的应用

Application of pleural fluid cell wax and"fresh"pleural fluid in EGFR gene detection of lung adenocarcinoma.

目的探讨胸水细胞蜡块与“新鲜”胸水在肺腺癌表皮生长因子受体(EGFR)基因突变检测中的应用效果。方法选取2018年1月至2019年6月在广东医科大学附属医院住院治疗的67例胸腔积液患者,胸水标本常规离心后将沉渣包埋制作成细胞蜡块,经免疫组化明确肺腺癌诊断,检测其EGFR基因的突变(实验组),将同期送检的一份“新鲜”胸水的EGFR基因检测情况作为对照组。EGFR无任何突变的样本为EGFR阴性,而EGFR有任何突变类型的样本为EGFR阳性,比较两组标本的阳性率。结果实验组标本中的EGFR阳性率为62.69%(42/67),明显高于对照组的44.78%(30/67),差异有统计学意义(P<0.05);两组标本同为阳性27例,同为阴性22例。结论与“新鲜”胸水比较,胸水细胞蜡块用于肺腺癌的EGFR基因突变检测更为可靠,能有效指导其分子靶向治疗,值得推广。

Objective To explore the effect of pleural fluid cell wax and"fresh"pleural fluid on the detection of EGFR(epithelial growth factor receptor)gene mutation in lung adenocarcinoma.Methods A total of 67 patients with lung adenocarcinoma,who received in-patient treatment at the Affiliated Hospital of Guangdong Medical University from January 2018 to June 2019,were selected.The pleural fluid samples were routinely centrifuged and then the sediment was embedded into cell wax blocks.The diagnosis of lung adenocarcinoma was confirmed by immunohistochemistry,and EGFR gene mutation was detected as the experimental group.The EGFR gene detection of a"fresh"pleural fluid was taken as the control group at the same time.Samples with no mutations of EGFR were EGFR negative,and those with any mutations of EGFR were EGFR positive.The positive rates of the two groups were compared.Results The positive rate of EGFR in experimental group was 62.69%(42/67),which was significantly higher than 44.78%(30/67)in the control group(P<0.05).Conclusion Compared with"fresh"pleural fluid,pleural fluid cell wax is a more reliable way to detect EGFR gene mutation in lung adenocarcinoma.