表皮生长因子受体基因突变与肺腺癌临床特征的关系

Y. Miao, Xin-Jian Gao, Ya-Wen Zheng, Zhihong Zhao, Y. Liu
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摘要

目的探讨表皮生长因子受体(EGFR)基因突变与肺腺癌临床特征的关系。方法收集2017年1月至2019年1月郑州大学第一附属医院经肺切除术(肺切除术、楔形切除术或肺叶切除术)诊断为肺腺癌的194例患者的临床资料。分析EGFR基因突变与肺腺癌患者性别、年龄、吸烟史、肿瘤标志物、腺癌病理分型、分化程度等临床病理特征的关系,进一步寻找预测EGFR突变的因素。结果194例肺腺癌患者中,EGFR基因突变120例(61.86%),女性突变率高于男性(χ2=10.746, P=0.001),年龄≥60岁的患者EGFR基因突变率高于年龄≥0.05的患者。在肺腺癌的主要病理类型中,腺泡型在EGFR突变组中所占比例最高(63.9%,124/194),其余为实体型、乳头状型、粘附型、黏液型腺癌,主要病理类型与EGFR基因突变、各切除病灶的分化程度差异均有统计学意义(χ2=10.275, 17.131;P = 0.001, 0.001)。EGFR突变体中外显子19和外显子21较多,进一步分析发现,不同病理亚型间外显子19和外显子21突变量差异有统计学意义(χ2=18.613, P=0.001)。结论EGFR基因突变与性别、年龄、吸烟史、主要病理类型及肿瘤分化程度有关,与肿瘤标志物无关。外显子19和21的突变与主要病理类型有关。关键词:肺腺癌;表皮生长因子;受体;病理
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Relationship between gene mutation of epidermal growth factor receptor and clinical characteristics of lung adenocarcinoma
Objective To investigate the relationship between the gene mutation of epidermal growth factor receptor (EGFR) and the clinical characteristics of lung adenocarcinoma. Methods The clinical data of 194 patients with lung adenocarcinoma diagnosed by surgical resection (pulmonary resection, wedge resection, or lobectomy) in the First Affiliated Hospital of Zhengzhou University from January 2017 to January 2019 were collected. The relationship between EGFR gene mutation and clinicopathological characteristics including sex, age, smoking history, tumor markers, adenocarcinoma pathological classification, extent of differentiation in patients with lung adenocarcinoma were analyzed, further searched for factors that predicted the mutations of EGFR. Results In the 194 patients with lung adenocarcinoma, there were 120 cases (61.86%) with EGFR gene mutation, the mutation rate of female was higher than that of male (χ2=10.746, P=0.001), the mutation rate of EGFR gene in patients of age≥60 was higher than that in patients of age 0.05). Among the main pathological types of lung adenocarcinoma, the proportion of acinar type was the highest in EGFR mutation group(63.9%, 124/194), the others were solid type, papillary type, adherent type, mucinous adenocarcinoma, the differences between the main pathological types and EGFR gene mutation, the differentiation degree of each excised lesion were statistically significant (χ2=10.275, 17.131; P=0.001, 0.001). There were more exons 19 and exon 21 in EGFR mutants, further analysis showed that there was significant difference between different pathological sub-types and mutations of exon 19 and exon 21(χ2=18.613, P=0.001). Conclusions EGFR gene mutation is related to sex, age, smoking history, main pathological types and tumor differentiation degrees, but it is not related to tumor marker. Mutations of exon 19 and exon 21 are related to main pathological types. Key words: Lung adenocarcinoma; Epidermal growth factor; Receptor; Pathology
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