肺癌胸水细胞块与组织学EGFR基因扩增检测对比研究

摘要

目的:对比肺癌胸水细胞块与组织学中EGFR基因扩增情况,探讨非小细胞肺癌患者阳性胸水细胞块检测EGFR基因扩增情况及临床意义.方法:收集60例非小细胞肺癌患者阳性胸水离心获取肿瘤细胞制作成石蜡细胞块,其中有28例的组织学对照,免疫组化分型后进行FISH检测EGFR基因,荧光显微镜观察基因扩增情况.结果:28例细胞块有组织学EGFR基因检测对照,在有组织学对照细胞块EGFR基因检测相符率100％.肺腺癌31例中,EGFR基因簇状扩增4例(12.9％),点状扩增14例(45.2％),无扩增13例(41.9％),肺腺癌扩增率为58.1％;肺鳞癌25例中,EGFR基因簇状扩增2例(8.0％),点状扩增9例(36.0％),无扩增14例(56.0％),肺鳞癌扩增率为44.0％;其他类型NSCLC患者4例中2例点状扩增,扩增率为50％.结论:肺腺癌及肺鳞癌胸水细胞块EGFR检测结果与组织学一致,EGFR基因在肺腺癌的扩增率高于肺鳞癌.应用FISH技术检测胸水细胞块中的EGFR基因扩增情况具有临床应用价值.%Objective:The comparative study of fluorescence in situ hybridization( FISH) detected EGFR gene for the pleural fluid cell blocks and tissue of non - small cell lung cancer patients,to investigate the clinical application value of EGFR gene amplification in the pleural fluid cell blocks. Methods; The pleural fluid cell blocks from 60 pa-tients with NSCLC were collected,28 tissue sample in which. The EGFR gene amplification of the patients were detec-ted by FISH after different tissue types with immunohistochemical technique. Results;The result of EGFR gene amplirnfications in the 28 pleural fluid cell blocks of lung cancer patients is consistent with the tissue samples. In 31 of 60 NSCLC samples,EGFR gene amplifications were identified in 18 (58. 1% ,18 /31) ,in which 4 cases (12.9% ,4 / 31) were cluster amplification and 14 cases (45.2% ,14 /31) were multi -chromosomes amplification. In 25 squa-mous cell carcinoma,EGFR gene amplifications were identified in 11 (44. 0% ,11 /25) ,in which 2 cases (8. 0% ,2/ 25) were cluster amplification and 9 cases (36. 0% , 9 /25) were multi - chromosomes amplification. In 4 other tis-sue types, EGFR gene amplifications were identified in 2 ( 50% ,2 /4) ,in which 2 cases (50% ,2/4) were multi -chromosomes amplification. Conclusion: The result of EGFR gene amplifications in pleural fluid cell blocks of lung cancer patients is consistent with the tissue samples . The EGFR gene amplification ratio of adenocarcinoma is was higher than squamous cell carcinoma . The FISH detected EGFR gene effect were good for the pleural fluid Cell Blocks of lung cancer patients.