非小细胞肺癌EGFR和KRAS基因突变和临床病理特征分析

Analysis of EGFR and KRAS gene mutations and clinicopathological features in non-small cell lung cancer

目的探讨非小细胞肺癌(NSCLC)中表皮生长因子受体(EGFR)和鼠类肉瘤病毒癌基因(KRAS)突变状态及其与临床病理特征的关系。方法回顾性收集2019年1月至2021年6月首都医科大学大兴教学医院183例病理确诊NSCLC患者临床病理资料,采用扩增阻滞突变系统(ARMS)法检测肿瘤组织中EGFR和KRAS基因的突变状态,分析基因突变率及其与临床病理特征之间的关系。结果183例NSCLC中EGFR和KRAS基因的突变率分别为56.28%(103/183)、11.48%(21/183),EGFR和KRAS双基因突变率为0.55%(1/183)。EGFR基因突变多见于女性、无吸烟史、腺泡型为主的腺癌、淋巴结无转移患者;KRAS基因多见于男性、有吸烟史患者。结论NSCLC患者EGFR基因突变与患者性别、吸烟史、组织学类型、淋巴结转移相关,KRAS基因突变与患者性别和吸烟史有关,可出现EGFR与KRAS基因联合突变。EGFR、KRAS基因同步检测,有助于筛选EGFR-TKI靶向治疗对象,指导临床用药。

Objective To investigate the expression of epidermal growth factor(EGFR),Kirsten mouse sarcoma(KRAS)gene mutations and their clinicopathological features in non-small cell lung cancer(NSCLC)patients.Methods The clinicopathological data of 183 patients from January 2019 to June 2021 with pathologically confirmed NSCLC in Daxing Teaching Hospital,Capital Medical University were collected.Amplification refractory mutation system(ARMS)were used to detect EGFR and KRAS mutation in these 183 NSCLC samples,then the gene mutation rate and its relationship with clinicopathological characteristics were analyzed.Results The mutation rates of EGFR and KRAS were 56.28%(103/183)and 11.48%(21/183),respectively.And the combined mutation rate of EGFR and KRAS genes was 0.05%(1/183).The mutation of EGFR gene was more common among female,non-smoking history,acinar pattern-predominant adenocarcinoma and without lymph node metastasis patients.The mutation of KRAS gene was more common among male and smokers.There were 1 case of combined mutation about EGFR and KRAS genes.Conclusion The mutation status of EGFR gene was correlated with gender,smoking history,histological type and lymph node metastasis.The mutation status of KRAS gene was correlated with gender and smoking history.The mutations in EGFR and KRAS can exist at the same time.Detection of the mutation status of EGFR and KRAS genes is helpful for screening patients for EGFR-TKI targeted therapy and guiding clinical medication.