探讨不同肺腺癌标本中EGFR突变和TTF-1表达的关系及临床意义

摘要

目的 探讨在不同肺腺癌标本中EGFR突变和TTF-1表达的关系及意义.方法 收集肺腺癌标本603例(手术标本343例、小活检176例及胸水细胞块86例),用扩增阻滞突变系统(amp1ification refrac-tory mutation system,ARMS)法检测EGFR的突变及用免疫组化方法检测TTF-1表达.结果 EGFR突变在手术组织172例(50.1%)、小活检90例(51.1%)及胸水细胞块48例(57.1%).TTF-1阳性在手术组织中206例(60.1%)、小活检98例(55.7%)及细胞块50例(59.5%).所有标本中EGFR突变310例(51.4%),TTF-1阳性356例(58.7%).所有突变中19外显子157例(50.6%)、21外显子143例(46.1%)、18外显子10例(3.3%).结论 胸水细胞块标本检测EGFR 突变与组织标本具有同样的效果.肺腺癌患者TTF-1表达与EGFR的突变在手术标本、小活检及胸水细胞块中都有高度相关性.TTF-1对EGFR突变也有比较好的提示作用.%Objective To analyze the relationship between TTF-1 expression and EGFR mutations in differ-ent specimens of lung adenocarcinoma. Methods 603 cases with lung adenocarcinoma were collected, including 343 cases of operation tissues,176 cases of biopsy tissues and 86 cases of pleural effusion cells block. Their TTF-1 expression and EGFR mutations were detected by immunohistochemistry and amp1ification refractory mutation system. Results There were 172 cases of EGFR mutations in surgical specimens(50.1%) and 90 cases in biopsy specimen (51.1%) and 48 cases in pleural effusion cells block specimen (57.1%). There were 206 cases of TTF-1 expres-sion in surgical specimens (60.1%) and 98 cases in biopsy specimen (55.7%) and 50 cases in pleural effusion cells block specimen (59.5%). There were 310 cases of EGFR mutations (51.4%) and TTF-1 expression (58.7%) in all patients,including 157 cases of 19-exons deletion(50.6%) and 143 cases of 21-exons point mutations (46.1%) and 10 cases of 18-exons point mutations(3.3%). Conclusion The detection of EGFR mutations in cells block has the same effect with its tissues. EGFR mutations is related with the expression of TTF-1 in different speci-mens of lung adenocarcinoma. TTF-1 positive expression can guide the EGFR mutations in lung adenocarcinoma.