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目的分析经支气管镜超声引导针吸活检术(endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TBNA)获取标本确诊肺腺癌患者表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变状况。方法回顾性分析复旦大学附属肿瘤医院胸外科2009年4月至2013年9月连续964例EBUS-TBNA术患者的临床资料,分析经细胞形态学和免疫组织化学染色检查确诊为肺腺癌的77例患者的EGFR基因突变情况。其中男48例、女29例,中位年龄61(33~78)岁,有吸烟史患者43例。结果 77例肺腺癌患者均经免疫酶标检测确认,全组共有EGFR基因突变患者31例,突变率为40.26%。EGFR基因突变患者性别差异无统计学意义(P=0.088);与吸烟的患者相比较,不吸烟的患者EGFR基因突变率较高,差异有统计学意义(P=0.032)。结论 EBUS-TBNA术获取的标本可以进行EGFR基因突变检测并获得准确的基因突变信息,不吸烟的患者EGFR基因突变比率较高。
Objective To analyze the mutations of epidermal growth factor receptor (EGFR) gene in patients with lung adenocarcinoma confirmed by EBUS-TBNA by bronchoscopy. Methods The clinical data of 964 consecutive EBUS-TBNA patients from April 2009 to September 2013 in Department of Thoracic Surgery, Affiliated Tumor Hospital of Fudan University were retrospectively analyzed. The results of cell morphology and immunohistochemistry were analyzed. Cases of patients with EGFR gene mutations. There were 48 males and 29 females, with a median age of 61 (33 to 78) years and 43 smokers. Results Totally 77 patients with lung adenocarcinoma were confirmed by enzyme-linked immunosorbent assay (ELISA). There were 31 patients with EGFR gene mutations in the whole group, the mutation rate was 40.26%. There was no significant difference in gender of patients with EGFR mutation (P = 0.088). Compared with smokers, non-smokers had higher rate of EGFR gene mutation, the difference was statistically significant (P = 0.032). Conclusion The specimens obtained by EBUS-TBNA can detect EGFR gene mutations and obtain accurate gene mutation information. The non-smoking patients have a higher EGFR gene mutation rate.