ADx-ARMS方法检测晚期非小细胞肺癌患者胸水标本癌细胞基因突变的临床意义

摘要

目的：探讨应用ADx-ARMS方法检测非小细胞肺癌患者胸水标本癌细胞基因突变应用于指导小分子EGFR酪氨酸激酶抑制剂（ EGFR-TKIs）治疗的可行性与临床意义。方法：ADx-ARMS检测24例非小细胞肺癌患者胸水标本EGFR基因第19、20和21外显子突变与KRAS基因第2外显子突变。统计分析胸水标本与前期检测过的非小细胞肺癌组织中的EGFR、KRAS突变率差异。结果：24例胸水标本中，EGFR突变与KRAS突变分别为14例（58.3％）和1例（4.2％）。前期检测过的非小细胞肺癌组织EGFR和KRAS突变率分别为47.6％和4.5％。EGFR和KRAS突变率在胸水标本与前期肺癌组织中差异无统计学意义（ P%Objective:To explore the clinical significance of ADx-ARMS to detect EGFR and KRAS gene muta-tions in pleural effusion of patients with non-small cell lung cancer( NSCLC)for guiding EGFR tyrosine kinase in-hibitor therapy. Methods:The mutations of EGFR gene in exon 19,20,21 and KRAS gene in exon 2 were detected with ADx-ARMS in 24 samples. The frequencies of EGFR and KRAS mutations between pleural effusion samples and cancer tissue samples from patients with NSCLC were analyzed statistically. Results:EGFR and KRAS mutations was 14 cases(58. 3%)and 1 case(4. 2%)among the 24 pleural effusion samples. The frequencies of EGFR and KRAS mutation detected in NSCLC tissues before were 47. 6% and 4. 5%,respectively. There was no significant difference in either EGFR or KRAS between pleural effusion fluid and cancer tissue samples. Conclusion:It is helpful to patients with advanced NSCLC who have lost the operation opportunity to detect the gene mutation in pleural effu-sion with ADx-ARMS in directing the EGFR tyrosine kinase inhibitors clinical treatment.