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754例Ⅰ期-Ⅲa期可手术切除非小细胞肺癌患者EGFR和KRAS基因突变状态及其临床意义
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754例Ⅰ期-Ⅲa期可手术切除非小细胞肺癌患者EGFR和KRAS基因突变状态及其临床意义
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754例Ⅰ期-Ⅲa期可手术切除非小细胞肺癌患者EGFR和KRAS基因突变状态及其临床意义
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Journal Article
754例Ⅰ期-Ⅲa期可手术切除非小细胞肺癌患者EGFR和KRAS基因突变状态及其临床意义
2017
Overview
背景与目的表皮生长因子受体（epidermal growth factor receptor,EGFR）和KRAS基因是非小细胞肺癌（non-small cell lung cancer,NSCLC）重要的分子靶点,但目前研究主要集中在晚期NSCLC组织和血浆标本的EGFR检测,早期NSCLC组织样本中EGFR和KRAS突变特征尚不清楚。本研究将探讨I期-IIIa期NSCLC EGFR和KRAS基因突变与相关临床病理特征的关系。方法采用突变扩增系统（amplification refractory mutation system,ARMS）PCR方法检测北京协和医院病理科提供的754例I期-IIIa期NSCLC组织样本的EGFR和KRAS基因突变状况,分析基因突变率及其与临床病理特征的关系。结果 EGFR和KRAS基因热点突变的突变率分别为34.5%和13.1%,其中有3例样本具有EGFR和KRAS基因的双突变。EGFR基因在女性中的突变率高于男性（39.5%vs 29.4%,P=0.076）,在腺癌中的突变率（38.7%）高于鳞癌、腺鳞癌、大细胞癌（P〈0.01）,但仍明显低于其他研究报道的亚裔晚期腺癌突变率（-50%）。KRAS基因突变在男性中的突变率高于女性（16.6%vs 9%,P=0.048）,且在腺癌中的突变率也高于其他类型,但差异不显著（P=0.268）。与KRAS基因突变阳性组相比,EGFR基因突变阳性组在年龄分布上有年轻化的趋势（P=0.031,5）,在性别分布上有显著性差异（P〈0.01）。结论 I期-IIIa期NSCLC EGFR基因突变率较晚期患者低,且EGFR和KRAS基因双突变的发生率为0.9%。
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