EGFR基因在肺微浸润性腺癌中的突变特征及意义

Characteristics and Significance of EGFR Gene Mutation in Lung Microinfiltrated Adenocarcinoma

目的了解肺微浸润性腺癌(LMIA)表皮生长因子受体(EGFR)的基因突变情况及其与组织病理特点间的关联。方法收集2016年1月至2018年10月本院经治LMIA 90例。收集术后肿瘤组织样本,记录患者临床及病理资料。检测相应EGFR基因突变情况。对所得临床数据及EGFR基因突变数据进行统计学分析。结果共发现野生型25例(27.78%),突变型65例(72.22%)。32例19Del突变(突变率35.56%),30例L858R突变(突变率33.33%),另有3例外显子18 G719X点突变(突变率3.33%)。EGFR突变与肿瘤尺寸、病灶纤维化及病灶炎症细胞浸润间均存在关联(P均<0.05),而与性别、年龄、吸烟情况、病灶数量、病灶位置及病理亚型间均无关联(P均>0.05)。19Del基因突变与年龄、病灶位置、肿瘤尺寸、病理亚型及病灶纤维化间均存在关联(P均<0.05),而与性别、吸烟情况、病灶数量及病灶炎症细胞浸润间均无关联(P均>0.05)。L858R基因突变与肿瘤尺寸、病理亚型及病灶炎症细胞浸润间均存在关联性(P均<0.05),而与性别、年龄、吸烟情况、病灶数量、病灶位置及病灶纤维化间均无关联(P均>0.05)。结论LMIA中EGFR基因突变发生率较高,整体及不同突变亚型与部分临床特征因素间存在一定关联。

Objective To learn the relationship between the epidermal growth factor receptor(EGFR)gene mutation and its corresponding histopathological features of lungmicroinfiltratedadenocarcinoma(LMIA),in order to provide reference for the development of clinical further treatment plans.Methods 90 cases of LMIA,treated in our hospital from January 2016 to October 2018,were collected.Clinical and pathological data of all cases and postoperative tumor tissue samples were collected.The corresponding EGFR gene mutation was detected.Statistical analysis was performed on the obtained clinical data and EGFR gene mutation data.Results A total of 25 cases(27.78%)were found in wild type and 65 cases(72.22%)were mutated.32 cases of 19Del mutation(mutation rate 35.56%),30 cases of L858R mutation(mutation rate 33.33%),and 3 exceptions of 18 G719X point mutation(mutation rate 3.33%).There was a correlation between EGFR mutation and tumor size,lesional fibrosis and inflammatory cell infiltration(P<0.05),but no association with gender,age,smoking status,number of lesions,lesion location and pathological subtype(P>0.05).There was a correlation between 19Del gene mutation and age,lesion location,tumor size,pathological subtype and lesional fibrosis(P<0.05),but no association with gender,smoking status,number of lesions and inflammatory cell infiltration of the lesion(P>0.05).There was a correlation between L858R gene mutation and tumor size,pathological subtype and inflammatory cell infiltration(P<0.05),but no association with gender,age,smoking status,number of lesions,lesion location and lesion fibrosis(P>0.05).Conclusion The incidence of EGFR gene mutations in LMIA is high,and there is a correlation between overall and different mutant subtypes and some clinical characteristics.