肺癌穿刺标本表皮生长因子受体基因突变检测的临床价值.pdf

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1、·1618·临床放射学杂志2012年第31卷第11期介入治疗肺癌穿刺标本表皮生长因子受体基因突变检测的临床价值冯勇，张晋，王海彦，张磊，史美祺，庄一平【摘要】目的评价肺癌穿刺针吸活检标本表皮生长因子受体(EGFR)基因突变检测的临床应用价值。方法对46例ⅢB一Ⅳ期肺癌患者行CT引导肺部病灶针吸活检术，应用PCR直接测序法检测穿刺标本EGFR外显子l9及21突变。结果(1)46例中腺癌40例、鳞癌3例、小细胞癌1例、未分化癌2例。(2)46例中EGFR突变24例；40例腺癌中23例发生突变，3例鳞癌中1例突变；30例女性中有2O例突变，16例男性中有4例突变。(3)

2、13例EGFR突变病例接受表皮细胞生长因子受体酪氨酸激酶抑制剂(EGFR．TKI)治疗6周后首次评估均为部分缓解(PR)。肿瘤进展时间(1TP)最短12周，最长102周。结论CT导向肺癌针吸活检标本能有效检测EGFR突变，可为进展期肺癌应用EGFR—TKI靶向药物治疗筛选优势人群。【关键词】肺癌表皮生长因子受体突变活检TheClinicalValueofEpidermalGrowthFactorReceptorGeneMutationsinLungCancerSpecimensObtainedByNeedleAspirationFENGYong，ZHANGJin，

3、WANGHaiyan，eta1．DepartmentofRadiology，CancerHospitalofJiangsuProvince，Nanjing210009，P．R．China【Abstract】ObjectiveToevaluatetheclinicalvalueofepidermalgrowthfactorreceptor(EGFR)genemutationsinlungcancerbyneedleaspirationbiopsy．Methods46patientswithadvancedlungcancerwereenrolledinthisstu

4、dy．AllpatientsunderwentCTguidedtransthoracicneedleaspirationbiopsyofthelungtumor．Thebiopsyspecimensweresentforhistopatho10calstudy，EGFRgenemutationswastakenwithPCRanddirectsequencingmethodwasusedtodetectdele-tionmutationandpointmutationinexon19or21．Results(1)Histologicalresultsinclude

5、dadenocareinoma(=40)，squamouscellcarcinoma(n=3)，smallcelllungcancer(n=1)andpoorlydifferentiatedcarcinomas(n=2)．(2)EGFRgenemutationsweredetectedin24ofthe46lungtumors．Of40adenocarcinomalesions，EGFRgenemutationsweredetec-tedin23．Of3squamouscellcarcinomalesions，EGFRgenemutationsweredetect

6、edin1．Among30femalespatients，EGFRgenemutationsweredetectedin20．Among16malespatients，EGFRgenemutationsweredetectedin4．(3)In24patientswithEGFRgenemutations，t3patientsweretreatedwithinhibitorsofthetyrosinekinaseofepidermalgrowthfactorreceptor(EGFRTKI)．Aftersixweeks，all13patientswerebenef

7、ited(partialresponse)fromthetreatment．Theshortesttimeoftumorprogression(rITI’P)was12weeks，andthelongestTTPwas102weeks．ConclusionCTguidedtransthorac—icneedleaspirationbiopsyofthelungtumorcandetectEGFRgenemutationsefectively．DetectionofEGFRgenemutationcanbeusedtochoosepatientswithadvanc

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