肺腺癌患者外周血中外泌体EGFR突变检测及其临床意义

Detection of exosomal EGFR mutations in peripheral blood of patients with lung adenocarcinoma and its clinical significance

目的:探讨肺腺癌患者外周血中外泌体检测EGFR的临床意义。方法:采用PCR方法检测肺腺癌患者外周血中外泌体、ctDNA和癌组织中EGFR突变情况,分析肺腺癌患者外周血外泌体中EGFR突变及其与临床病理特征的关系,比较外周血中外泌体、ctDNA和癌组织中检测EGFR突变的一致性。结果:肺腺癌患者外周血外泌体中检测EGFR突变型肺腺癌21例,EGFR野生型肺腺癌23例。肺腺癌外泌体中EGFR突变与性别、年龄、肿瘤大小、TNM分期、组织学类型及淋巴结转移情况比较差异无统计学意义(P>0.05)。肺腺癌组织检测25例EGFR突变中,外泌体中检测出EGFR突变19例,一致率为76%;19例肺腺癌组织EGFR野生型中,外泌体检测出EGFR突变2例。25例肺腺癌组织EGFR突变中,ctDNA中检测出EGFR突变16例,一致率为64%。kappa分析显示,外泌体、ctDNA与癌组织检测一致性较好,前者一致性优于后者。结论:外泌体可用于肺腺癌血浆中EGFR突变检测,对指导临床用药具有一定意义。

Objective:To investigate the clinical significance of EGFR in peripheral blood exosome of patients with lung adenocarcinoma.Methods:The EGFR mutations in peripheral blood exosome,ctDNA and cancer tissues were detected by PCR,and the relationship between EGFR mutations in exosome and clinicopathologic features were analyzed,to compare the consistency of EGFR mutations in exosomes,ctDNA and cancer tissues.Results:21 cases of EGFR mutation lung adenocarcinoma and 23 cases of EGFR wild lung adenocarcinoma were detected in the peripheral blood exosome of lung adenocarcinoma patients.There was no significant difference in EGFR mutation among gender,age,tumor size,TNM stage,pathological type and lymph node metastasis(P>0.05).Among 25 cases of lung adenocarcinoma,EGFR mutation was detected in 19 cases(76%)EGFR mutation was detected in 2 of 19 wild-type lung cancer tissues,and in 16 of 25 lung cancer tissues,EGFR mutation was detected in ctDNA(64%),the former is more consistent than the latter.Conclusion:Exosome can be used to detect EGFR mutations in plasma of lung adenocarcinoma,which has certain significance in guiding clinical drug use.