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目的:探讨EGFR 19缺失突变在非小细胞肺癌(NSCLC)组织中的表达及与临床病理特点的关系,为NSCLC TKI个体化靶向治疗提供临床依据。方法:收集第四军医大学唐都医院胸腔外科2010年9月至2013年11月手术切除经ARMS法检测为19-Del的NSCLC标本125例。免疫组化检测EGFR 19-Del表达,半定量分析其与临床病理特点的关系。结果:19-Del阳性着色呈棕黄色或深黄色颗粒样,主要定位在细胞膜上。鳞癌和腺癌相比,19-Del的表达强度无统计学差异(P=0.480)。19-Del在肺腺癌病理分级、TNM分期、原发肿瘤大小、淋巴结转移状态以及肿瘤位置间表达差异显著(P值均<0.05),而在鳞癌组间差异无统计学意义(P值均>0.05)。另外,19-Del表达在性别、年龄、吸烟史组中差异性不显著(P值均>0.05)。19-Del的阳性程度与ARMS法RT-PCR中Ct值之间有较强负相关性(P=0.000,rs=-0.662)。结论:19-Del表达强度与NSCLC的病理分级、TNM分期、淋巴结转移状态等相关,提示19-Del很可能具有促进肺癌发生发展的作用。免疫组化方法检测EGFR 19缺失突变结果与ARMS法一致性较好,方法可行。
Objective: To investigate the expression of EGFR 19 deletion mutation in non-small cell lung cancer (NSCLC) and its relationship with clinicopathological features, and to provide a clinical basis for targeted therapy of TKI in NSCLC. Methods: Totally 125 NSCLC specimens with 19-Del treated by ARMS were collected from September 2010 to November 2013 in Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University. Immunohistochemical detection of EGFR 19-Del expression, semi-quantitative analysis of its relationship with clinicopathological features. RESULTS: The positive staining of 19-Del was brownish yellow or dark yellow, mainly located on the cell membrane. There was no significant difference in the expression of 19-Del between squamous cell carcinoma and adenocarcinoma (P = 0.480). The expression of 19-Del in lung adenocarcinoma was significantly different between the pathological grading of lung adenocarcinoma, TNM stage, primary tumor size, lymph node metastasis status and tumor location (all P <0.05), but there was no significant difference between the squamous cell carcinoma group (P value All> 0.05). In addition, the expression of 19-Del was not significantly different in gender, age and smoking history group (all P> 0.05). There was a strong negative correlation between the positive degree of 19-Del and the Ct value of ARMS RT-PCR (P = 0.000, rs = -0.662). Conclusion: The intensity of 19-Del expression is correlated with the pathological grade of NSCLC, TNM stage and lymph node metastasis, suggesting that 19-Del may have a role in promoting the development of lung cancer. Immunohistochemical detection of EGFR 19 deletion mutation results and ARMS consistency is good, the method is feasible.