驱动基因EGFR/ALK/ROS1均阴性的肺腺癌和肺鳞癌的临床病理特征研究

Clinicopathological characteristics of lung adenocarcinoma and lung squamous cell carcinoma with negative driving genes EGFR/ALK/ROS1

目的:研究驱动基因表皮生长因子受体(epidermal growth factor receptor,EGFR)/间变淋巴癌激酶(anaplastic lymphoma kinase,ALK)/原癌基因1受体络氨酸激酶(c-ros oncogene 1 receptor tyrosine kinase,ROS1)均阴性的肺腺癌和肺鳞癌的临床病理特征。方法:回顾性分析96例EGFR/ALK/ROS1均阴性的肺腺癌和肺鳞癌患者临床病理特征及差异。结果:(1)在性别、吸烟史、首发胸闷胸痛症状上,两组均存在差异;(2)鳞状上皮细胞癌抗原(squamous cell carcinoma antigen,SCCA)在鳞癌组中阳性率(50.0%)显著高于腺癌组(9.3%)(P<0.001),细胞角蛋白19片段(cytokeratin 19 fragment,CYFRA21-1)在鳞、腺癌两组阳性率均较高(78.6%vs 51.9%),但鳞癌组阳性率更高(P=0.007);(3)在肺内转移上,腺、鳞两组为40.7%vs 21.4%(P=0.045);(4)腺癌组鼠类肉瘤病毒癌基因(kirsten rat sarcoma viral oncogene,KRAS)(+)与鳞癌组相比为29.6%vs 11.9%(P=0.037);(5)鳞癌组肿瘤突变负荷≥10个突变/Mb的比例明显大于腺癌组(35.7%vs 16.7%)(P=0.033)。结论:EGFR/ALK/ROS1均阴性的肺腺癌和肺鳞癌临床病理特征存在一定的差异,有助于临床诊治。

Objective:To study the clinicopathologic features of lung adenocarcinoma and lung squamous cell carcinoma with epidermal growth factor receptor(EGFR)/anaplastic lymphoma kinase(ALK)/c-ros oncogene 1 receptor tyrosine kinase(ROS1)negative driver gene.Methods:The clinicopathologic features and differences of 96 patients with lung adenocarcinoma and lung squamous cell carcinoma with EGFR/ALK/ROS1 negative were retrospectively analyzed.Results:(1)There were differences between the two groups in gender,smoking history and first symptoms of chest tightness and pain.(2)Squamous cell carcinoma antigen(SCCA)was highly expressed in squamous cell carcinoma group(50.0%)than in adenocarcinoma group(9.3%)(P<0.001).The positive rate of cytokeratin 19 fragment(CYFRA21-1)was higher in both squamous cell carcinoma group and adenocarinoma group(78.6%vs 51.9%)but higher in squamous cell carcinoma group(P=0.007).(3)In terms of intrapulmonary metastasis,adenocarcinoma,squamous cell carcinoma were 40.7%vs 21.4%(P=0.045).(4)Kirsten rat sarcoma viral oncogene(KRAS)(+)in adenocarcinoma group compared with squamous cell carcinoma group was 29.6%vs 11.9%(P=0.037).(5)The proportion of tumor mutation burden≥10 mutations/Mb in squamous cell carcinoma group was significantly higher than that in adenocarcinoma group(35.7%vs 16.7%)(P=0.033).Conclusion:The clinicopathpologic features of lung adenocarcinoma and lung squamous cell carcinoma with EGFR/ALK/ROS1 are different,which is helpful for clinical diagnosis and treatment.