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目的分析表皮生长因子受体(epidermal growth factor,EGFR)基因突变在非小细胞肺癌阳性胸水中的表达情况。方法将胸水内查见非小细胞肺癌的病例其阳性胸水离心沉渣制作细胞块。分离细胞块样品DNA,使用实时荧光检测PCR(ARMS-PCR)检测215例非小细胞肺癌细胞块和404例非小细胞肺癌组织块中EGFR的29种突变类型,并检测细胞块同时送检组织块的患者74例的一致性。结果细胞块EGFR基因突变型102例,突变率47.44%(102/215);组织块EGFR突变型172例,突变率42.57%(172/404);74例有组织块对照的细胞块EGFR结果一致性有53例,一致率达71.62%(53/74),其中细胞块EGFR的突变率44.59%(33/74),组织块突变率70.27%(52/74)。结论可以应用非小细胞肺癌阳性胸水细胞块代替肿瘤组织检测EGFR基因突变,对指导晚期肺腺癌患者靶向药物治疗具有重要指导意义。
Objective To analyze the expression of epidermal growth factor receptor (EGFR) gene mutation in non-small cell lung cancer positive pleural effusion. Methods The pleural effusion was examined in the case of non-small cell lung cancer. Positive pleural effusion was used to make cell mass. The cell block sample DNA was isolated and real-time fluorescent detection PCR (ARMS-PCR) was used to detect 29 types of EGFR mutations in 215 non-small cell lung cancer cell masses and 404 non-small cell lung cancer tissue masses. The consistency of the 74 patients in the block. RESULTS: There were 102 cases of EGFR gene mutations in the cell mass, and the mutation rate was 47.44% (102/215). In the tissue mass, 172 mutations were detected in 172 cases, and the mutation rate was 42.57% (172/404). There were 53 cases with a concordance rate of 71.62% (53/74). The mutation rate of EGFR in the cell mass was 44.59% (33/74) and the mutation rate in the tissue block was 70.27% (52/74). Conclusions The non-small cell lung cancer positive pleural effusion cell mass can be used instead of tumor tissue to detect EGFR gene mutation, which is of great significance in guiding targeted drug treatment for patients with advanced lung adenocarcinoma.