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目的探讨表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变与表现为局灶性磨玻璃病变(f GGL)的肺恶性肿瘤的关系。方法回顾性分析2012年8月至2015年2月长征医院胸心外科行手术治疗的肺恶性f GGL 86例患者的临床资料,其中男26例、女60例,年龄(56.14±10.55)岁,分析其EGFR基因突变结果与各临床因素的关系。结果术后病理结果示不典型腺瘤样增生伴局灶原位癌或原位癌10例,微浸润性腺癌15例,腺癌61例;EGFR基因突变43例,其中19号外显子19-del突变14例,21号外显子L858R突变27例,21号外显子L861Q突变2例。EGFR基因突变与性别、肿瘤直径、病理类型、病理分期、肿瘤有无实性成分、胸膜有无侵犯、病灶个数等临床因素均无显著相关(P>0.05),高龄、不吸烟患者EGFR基因突变率高于低龄及吸烟患者,差异具有统计学意义(P<0.05)。随访日期截至2015年6月30日,入组患者全部存活,随访时间(440.48±186.61)d。结论 EGFR基因在肺恶性f GGL患者中有较高的突变率,为肺恶性f GGL的基础研究和临床治疗提供重要参考。
Objective To investigate the relationship between epidermal growth factor receptor (EGFR) gene mutations and malignant tumors of the lung with focal glaucoma lesions (f GGL). Methods The clinical data of 86 patients with lung malignant f GGL surgically treated in the Department of Cardiac Surgery, Changzheng Hospital from August 2012 to February 2015 were retrospectively analyzed. There were 26 males and 60 females with a mean age of 56.14 ± 10.55 years, Analysis of EGFR gene mutation results and the relationship between various clinical factors. Results The pathological findings showed atypical adenoma-like hyperplasia with focal in situ or in situ carcinoma in 10 cases, microinvasive adenocarcinoma in 15 cases and adenocarcinoma in 61 cases. EGFR gene mutation in 43 cases, of which 19 exon 19- There were 14 cases of del mutation, 27 cases of exon 21 L858R mutation and 21 cases of exon 21 L861Q mutation in 2 cases. The EGFR gene mutation had no significant correlation with clinical factors such as gender, tumor diameter, pathological type, pathological stage, presence or absence of solid tumor, pleural invasion, number of lesions and other clinical factors (P> 0.05) The mutation rate was higher than younger patients and smokers, the difference was statistically significant (P <0.05). Follow-up date As of June 30, 2015, all the patients survived, with a follow-up time of (440.48 ± 186.61) d. Conclusion The EGFR gene has a high mutation rate in patients with malignant f GGL. It provides an important reference for the basic research and clinical treatment of malignant f GGL in lung.