免疫组化法检测恶性胸腔积液脱落细胞EGFR突变状态
| 作者: |
1,2,2郭海华,
2黄立军,
2张志培,
2王磊
1 陕西省城固县桔园镇中心卫生院，陕西 汉中 723203 2 第四军医大学唐都医院胸腔外科，西安 710038 |
| 通讯: |
王磊
Email: tuodi1986@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2015.07.021 |
| 基金: | 第四军医大学唐都医院基础研究创新基金和苗子人才基金 |
摘要
目的：评估免疫组织化学染色法(immunohistochemistry，IHC)在恶性胸腔积液脱落细胞EGFR突变检测中的应用价值。方法：连续纳入我院2012年1月至2013年12月154例肺腺癌患者，筛选合格病例入组，使用扩增阻滞突变系统技术(amplification refractory mutation system，ARMS)和IHC分别检测肺癌组织和胸腔积液脱落细胞的EGFR突变状态。比较两种方法的检测敏感度、特异度和一致率等。结果：85例患者最终纳入本研究，患者平均年龄66.4岁。ARMS法检测肿瘤组织的总体突变率约49.4%，其中E746_A750 del突变率17.6%，L858R突变率22.4%。以ARMS法为金标准，IHC染色检测E746_A750 del和L858R突变的敏感度分别为93.3%和89.5%，两种方法的检测一致性极好。进一步，85例患者胸腔积液的脱落肿瘤细胞检出率为41.2%，IHC法检测E746_A750 del和L858R突变的敏感度分别为83.3%和66.7%，特异度均为100.0%。结论：IHC染色是一种可靠、准确的EGFR突变检测方法，能够获得良好的特异度和一致率，可用于恶性胸腔积液脱落肿瘤细胞的常规筛查。
关键词：
肺腺癌
EGFR突变
免疫组化法
扩增阻滞突变系统技术
Detecting the EGFR mutation status of malignant pleural effusion by immunohistochemistry
CorrespondingAuthor: WANG Lei Email: tuodi1986@126.com
DOI: 10.3978/j.issn.2095-6959.2015.07.021
Abstract
Objective: To assess the availability of immunohistochemistry (IHC) for detection of EGFR mutation status of malignant pleural effusion. Methods: From January 2012 to December 2013, 154 patients with lung adenocarcinoma were enrolled into this research, and amplification block mutation system technology (ARMS) and IHC were used to detect the mutation status of malignant pleural effusion. The sensitivity, specificity and concordance rate were compared between the ARMS and IHC methods. Results: A total of 85 patients with average age of 66.4 years were selected into this study finally. The overall mutation rate tested by ARMS method was about 49.4%, including 17.6% of E746_A750 del and 22.4% of L858R. As compared with ARMS, the IHC method contributed the sensitivity of E746_A750 del and L858R with 93.3% and 89.5%, respectively. Furthermore, IHC devoted an overall mutation rate of 41.2% in detecting exfoliative cells of malignant pleural effusion, involving the sensitivity of 83.3% for E746_A750 del and 66.7% for L858R, which had a specificity of 100%. Conclusion: IHC was a reliable and precise tool for detecting the EGFR mutation status in malignant pleural effusion, which can be used as a screening method.