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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～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19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20例突变,16例男性中有4例突变。(3)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(TTP)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。
Objective To evaluate the clinical value of epidermal growth factor receptor (EGFR) gene mutation detection in lung biopsy specimens. Methods Forty-six patients with stage ⅢB-Ⅳ lung cancer underwent needle-aspiration biopsy with CT-guided pulmonary lesions. The EGFR exon 19 and 21 mutations were detected by PCR direct sequencing. Results (1) 46 cases of adenocarcinoma in 40 cases, squamous cell carcinoma in 3 cases, small cell carcinoma in 1 case, undifferentiated carcinoma in 2 cases. (2) There were 24 EGFR mutations in 46 cases, 23 cases in 40 cases of adenocarcinoma, 1 case of squamous cell carcinoma in 3 cases, 20 cases in 30 cases and 4 cases in 16 cases. (3) The partial response (PR) was evaluated for the first time after 13 weeks of EGFR-TKI treatment in 13 patients with EGFR mutation. Tumor progression time (TTP) of at least 12 weeks, up to 102 weeks. Conclusion CT-guided needle aspiration biopsy can effectively detect EGFR mutations, which can be used to screen the dominant population for advanced lung cancer with EGFR-TKI targeted drug therapy.