肺腺癌中联合检测EGFR蛋白及EGFR基因的临床意义

Clinical significance of combined detection of EGFR protein and EGFR gene in lung adenocarcinoma

目的探讨在肺腺癌中联合检测EGFR蛋白及基因的临床工作意义。方法采用免疫组化(IHC)和蝎型探针扩增阻滞突变-荧光定量聚合酶链反应(ARMS-qPCR),同时检测195例肺腺癌组织中EGFR蛋白表达和基因突变状态,采用IHC法检测195例癌周正常肺组织中EGFR蛋白的表达。结果1、肺腺癌组织中EGFR蛋白阳性表达率显著高于正常肺组织中(χ^(2)=106.733,P<0.001);2、EGFR蛋白的表达与肿瘤大小、有无淋巴结转移、TNM分期相关(P均<0.05),EGFR基因的突变与患者性别和是否吸烟相关(P均<0.05),EGFR蛋白和基因共表达与肿瘤大小、分化程度、TNM分期相关(P均<0.05),EGFR 21号位点突变与性别有关(P<0.05);3、EGFR蛋白阳性组中基因突变率显著高于阴性组(Z=-8.912,P<0.001)。结论结合EGFR蛋白及基因表达与临床病理因素间的关系以及检测的经济社会效益,建议对于女性、吸烟患者且EGFR蛋白强表达的病例进一步行EGFR基因检测,从而更精准、经济的筛选出潜在可能的基因突变患者。

Objective To explore the clinical significance of combined detection of EGFR protein and gene in lung adenocarcinoma.Methods Immunohistochemistry(IHC)and amplification-resistant mutation system fluorescence quantitative polymerase chain reaction(ARMS-qPCR)were used to simultaneously detect EGFR protein expression and gene mutation status in 195 lung adenocarcinoma tissues.Meanwhile,the expression of EGFR protein in 195 normal lung tissues around cancer was also detected by IHC.Results 1.The positive expression rate of EGFR protein in lung adenocarcinoma tissue was significantly higher than those in normal lung tissue(χ^(2)=106.733,P<0.001).2.The expression of EGFR protein was correlated with tumor size,lymph node metastasis,and TNM stage(all P<0.05).The mutation of the EGFR gene was correlated with patient gender and smoking(P<0.05).The co-expressionof EGFR protein and gene was correlated with tumor size,degree of differentiation,and TNM stage(P<0.05),and EGFR mutation at site 21 was related to gender(P<0.05).3.The gene mutation rate in the EGFR protein positive group was significantly higher than that in the negative group(Z=-8.912,P<0.001).Conclusions Combined with the relationship between EGFR protein and gene expression and clinicopathological factors as well as economic and social advantage,it is recommended to further conduct EGFR gene detection for females,smoking patients,and cases with strong EGFR protein expression,so as to screen out potential genetic mutation patients more accurately and economically.