非小细胞肺癌患者组织原发灶和转移灶中ROS1融合基因的研究

摘要

Objective: To examine the positive rate ofROS1 fusion gene in primary and metastatic non-small cell lung cancer (NSCLC), and to explore their relationships.Methods: From January 2013 to May 2015, a total of 384 cases of primary NSCLC consisting of 246 cases of paired metastatic tumors and 47 cases of normal lung specimens as the control group were collected in the Military General Hospital of Beijing, Affliated Hospital of Academy of Military Medical Sciences, Zhejiang Cancer Hospital, Zhongshan Hospital of Dalian University, Shanxi Da Hospital, Shanxi Academy of Medical Sciences. hTe positive rate ofROS1 fusion gene among NSCLC population was ifgured out, thus the consistency ofROS1 fusion gene in advanced primary NSCLC and associated metastases and the relationship betweenROS1 fusion gene and clinical data was analyzed.Results: hTe positive rate ofROS1 fusion gene on primary tumor was 2.60% (10/384). For those 246 paired cases, the positive rate on primary tumor was 2.85% (7/246), with that of metastases 1.63% (4/246). Among the 246 cases, there were 1 case whose metastases were positive but primary tumors negative and 4 case whose primary tumor was positive but metastases negative. Positive rate ofROS1 fusion gene was higher in the primary lesions than metastases. It was of statistical signiifcance between the two groups (χ2=52.341,P=0.000). hTe positive rate of primary tumors could be predicted by metastases (κ=0.536,P=0.000). hTe sensitivity was 42.86% (3/7) and the speciifcity was 99.58% (238/239). Conclusion: hTe metastases of non-small cell lung cancer can predictROS1 fusion gene of the primary lesions. It can be used as alternative means for metastases to detectROS1 fusion gene which are not readily available.%目的：研究晚期非小细胞肺癌(non-small cell lung cancer，NSCLC)原发灶和转移灶ROS1融合基因阳性率，探讨其相关性。方法：收集2013年1月至2015年5月中国人民解放军北京军区总医院、军事医学科学院附属医院、浙江省肿瘤医院、大连大学附属中山医院和山西医学科学院山西大医院原发灶384例，其中配对转移灶246例，统计得出ROS1融合基因阳性率并分析原发灶与转移灶ROS1融合基因的一致性、ROS1融合基因阳性与临床基线资料间的关系。结果：ROS1融合基因阳性率原发灶为2.60%(10/384)。ROS1融合基因阳性率配对原发灶为2.85%(7/246)，配对转移灶为1.63%(4/246)，配对的246对原发灶、转移灶组织中，转移灶融合基因阳性而对应的原发灶融合基因阴性1例，原发灶融合基因阳性而对应的转移灶融合基因阴性4例，转移灶较原发灶检出ROS1融合基因阳性率高，两者差别有统计学意义(χ2=52.341，P=0.000)；转移灶和原发灶ROS1融合基因阳性的一致率好(κ=0.536，P=0.000)，通过转移灶判断原发灶融合阳性的情况，敏感性为42.86%(3/7)，特异性为99.58%(238/239)。结论：非小细胞肺癌中转移灶可以预测原发灶ROS1融合基因情况，在难以取得原发灶的情况下转移灶可以作为ROS1融合基因测的备选手段。