表现为磨玻璃样病变的肺腺癌临床特点与EGFR及K-RAS基因突变的关系

Relationship of Clinical Characteristics and EGFR, K-RAS Mutation in Lung Adenocarcinoma Patients with Predominant Ground-glass Opacity

目的探讨表现为磨玻璃样病变(GGO)的肺腺癌的临床特点与EGFR及K-RAS基因突变关系。方法连续选择37例经胸腔镜手术及病理证实为肺腺癌的肺GGO病例,分析其临床特点,检测EGFR与K-RAS基因突变情况,及与各临床因素之间的关系。结果 34例行肺叶切除术,3例行肺楔形切除术,术后病理结果显示:16例为原位腺癌,13例为微浸润腺癌,8例为浸润性腺癌。EGFR基因突变22例,K-RAS基因突变1例;在单纯型GGO及混合型GGO病例中,EGFR与K-RAS基因突变均无明显差异;在女性、不吸烟病例中EGFR基因突变相较男性及吸烟病例差异具有统计学意义(P<0.05)。结论 EGFR基因在表现为GGO的肺腺癌病例中表现出较高的突变率,为肺GGO病例临床治疗提供了重要参考。

Objective To investigate the relationship between clinical characteristics and EGFR,K-RAS mutation in 37 lung adenocarcinoma patients with predominant ground-glass opacity (GGO).Methods We reviewed the records of 37 lung adenocarcinoma patients with GGO diagnosed by thoracoscopy surgery and postoperative pathology.We analyzed the clinical characteristics and EGFR,K-RAS genic mutation and examined their relationship.Results Among the 37 patients,34 patients received lobectomy,and the other 3 patients underwent wedge resection of lung.Postoperative pathological diagnosis result was 16 cases of adenocarcinoma in situ (AIS),13 cases of micro-infiltrating adenocarcinoma (MIA)and 8 cases of infiltrating adenocarcinoma.EGFR mutation was present in 22 cases and K-RAS mutation was observed in one case.There was no significant difference in EGFR and K-RAS mutation between of pGGO cases and mGGO cases,while EGFR mutation were more common in non-smokers and female(P＜0.05).Conclusion Lung adenocarcinoma with dominant GGO possess higher EGFR mutations,which could provide definite important reference for clinical molecular targeted therapy for lung GGO patients.