276例手术切除肺腺癌亚型与EGFR/ALK基因状态
| 作者: |
1庄武,
2钟礼花,
2陈芳芳,
2陈燕坪,
1黄韵坚,
1黄章洲,
2卢建平,
2王晓江,
2师怡,
2林贤东,
2许春伟,
2陈刚
1 福建医科大学附属福建省肿瘤医院胸部肿瘤内科，福州 350014 2 福建医科大学附属福建省肿瘤医院病理科，福州 350014 |
| 通讯: |
黄韵坚
Email: 13805099580@126.com 许春伟 Email: xuchunweibbb@163.com 陈刚 Email: naichengang@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2017.04.002 |
| 基金: | 国家临床重点专科建设项目, 2013 福建省科技厅引导性项目, 2015Y0011，2016Y0019 |
摘要
目的：探讨手术切除肺腺癌各亚型EGFR和ALK基因状态分布。方法：应用ARMS方法检测手术切除肺腺癌石蜡组织中EGFR基因突变和ALK融合基因情况。结果：276例肺腺癌手术样本中，EGFR基因突变率为54.71%(151/276)，其中19del为28.99%(80/276)，L858R为23.19%(64/276)，20-ins为0.72%(2/276)，L861Q为0.72%(2/276)，G719X为1.09%(3/276)，S768I为0.36%(1/276)和T790M为0.72%(2/276)，其中包含G719X+S768I，19del+T790M，L858R+T790M各1例，ALK基因融合阳性率为5.80%(12/207)，在肺腺癌各亚型中EGFR基因突变附壁状腺癌，腺泡状腺癌，乳头状腺癌，实体状腺癌和浸润性黏液腺癌之间差异有统计学意义(P<0.001，P=0.009，P=0.023，P<0.001和P=0.030)，与其他类型之间差异均无统计学意义(P>0.05)；在肺腺癌各亚型中ALK融合基因突变各亚型之间差异均无统计学意义(P>0.05)。结论：肺腺癌组织学亚型与EGFR基因突变有关，附壁状腺癌、腺泡状腺癌和乳头状腺癌出现EGFR基因突变比其他亚型更加明显。
关键词：
肺腺癌
手术
EGFR基因
ALK基因
突变率
EGFR/ALK gene status of 276 cases of surgically resected lung adenocarcinomas
CorrespondingAuthor: HUANG Yunjian Email: 13805099580@126.com
DOI: 10.3978/j.issn.2095-6959.2017.04.002
Abstract
Objective: To investigate the mutations of EGFR gene and ALK fusion gene in surgically resected lung adenocarcinomas. Methods: ARMS method was used to detect the tissues in 276 patients of surgically resected lung adenocarcinomas with paraffin tissue EGFR gene mutation and ALK fusion gene. Results: The total mutation rate in 276 patients of surgically resected lung adenocarcinomas was 54.71% (151/276). EGFR gene mutation rate were found in 19del (28.99%, 80/276), L858R (23.19%, 64/276), 20-ins (0.72%, 2/276), L861Q (0.72%, 2/276), G719X (1.09%, 3/276), S768I (0.36%, 1/276) and T790M (0.72%, 2/276) in surgically resected lung adenocarcinomas, including one case of G719X+S768I, 19del+T790M, L858R+T790M, respectively. The total fusion positive rate in 207 patients of surgically resected lung adenocarcinomas was 5.80% (12/207). There were statistically significant (P<0.001, P<0.001, P=0.023, P<0.001 and P=0.030) in each subtype of lung adenocarcinoma of EGFR gene mutation, including lepidic predominant adenocarcinoma, acinar predominant adenocarcinoma, papillary predominant adenocarcinoma, solid predominant adenocarcinoma and invasive mucous adenocarcinoma, and there were not statistically significant (P>0.05) among other types. There were not statistically significant (P>0.05) among each types of lung adenocarcinoma of ALK fusion gene. Conclusion: Histologic subtyping was found to be associated with EGFR mutations. The EGFR mutation frequency of lepidic predominant, acinar predominant and papillary predominant subtypes was found to be more pronounced than that of other subtypes.