文章摘要
冯征 朱恺 周勇安 何铭 张志培△.EML-ALK突变阳性的肺癌患者EGFR突变检测及其临床特征[J].,2016,16(32):6265-6268
EML-ALK突变阳性的肺癌患者EGFR突变检测及其临床特征
Detection of EGFR Mutation and Analysis of Its Clinical Features in PrimaryLung Cancer Patients with EML4-Alk Fusion Gene
  
DOI:
中文关键词: EML4-ALK 融合基因  EGFR突变  原发性肺癌
英文关键词: EML4-ALK fusion gene  EGFR mutation  Primary lung cancer
基金项目:国家自然科学基金项目(81172224)
作者单位
冯征 朱恺 周勇安 何铭 张志培△ 第四军医大学唐都医院胸腔外科 
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中文摘要:
      目的:检测表皮生长因子受体(epidermal growth factor receptor, EGFR)在间变性淋巴瘤激酶(anaplastic lymphoma kinase, ALK)融合基因突变的原发性肺癌(primary lung cancer)人群中的突变率,并分析其与病人临床病理特征间的关系。方法:入选的 106例病例均为中国西北五省人群,且经ALK 融合基因检测为阳性。将106 例患者的组织标本采用ARMS 方法检测EGFR基因 18-21 外显子的突变情况,统计分析双突变患者的临床病理特征。结果:106 例ALK 融合基因突变阳性的原发性肺癌患者的组织 标本,有7 例(6.6 %)同时存在EGFR突变,其中19 外显子缺失突变(19-del)的3 例(42.9 %),L858R突变的2 例(28.5 %),L861Q 和G719X 突变的各1 例(14.3 %);7 例ALK 和双突变的患者中ALK 融合基因的突变均为EML4-ALK突变亚型1 (variant 1, V1)。7 例双阳性的患者中,6 例患者的年龄小于总体患者的中位年龄(53 岁),占85.7 %;男性患者4 例,占57.1 %;不吸 烟患者7 例,占100 %;腺癌患者4 例,占57.1 %,其中女性3例;肉瘤样癌2例,占28.6 %;粘液表皮样癌1例,占14.3 %。结论: EML4-ALK融合基因和EGFR突变能够共存,在EML4-ALK阳性的肺癌患者中,EGFR的突变率为6.6 %,双突变的患者大多年 轻且均无吸烟史,且双突变的女性患者均为腺癌。
英文摘要:
      Objective:To detect the frequency of EGFR mutation in primary lung cancer patients who had EML4-ALK fusion gene, and to analyze the relationship between EGFR mutation and clinical features.Methods:One hundred and six northwest Chinese patients with primary lung cancer were selected on the basis of EML4-ALK fusion gene. The EML4-ALK fusion gene was identified by single tube multiplex RT-PCR. In EML4-ALK positive samples, exon 18 to 21 EGFR mutations were detected by ARMS method. The clinical pathological features of patients with double mutations were statistically analyzed.Results:Seven specimens (6.6 % ) were identified with EGFR mutation from 106 cases with EML4-ALK fusion mutation.All 7 double positive cases were EML4-ALK variant 1 (V1), 19 exons deletion mutation (19-del) in 3 cases (42.9 %),EGFR L858R mutations in 2 cases (28.5 %), and L861Q G719X mutation of each 1 case (14.3 %). In 7 cases of double positive mutation patients, 6 patients were younger than overall in patients with a median age (53), accounting for 85.7 %. 4 cases (57.1 %) were male, all of 7 patients had no smoking history. The pathologic type included 4 case of adenocarcinoma (57.1 %), 2 case of sarcomatoid carcinoma (28.6 %), 1 case of mucous epidermoid carcinoma (14.3 %), in the 4 cases of adenocarcinoma, 3 cases were female.Conclusion: EML4-ALK fusion gene and EGFR mutations can coexist. In EML4-ALK positive lung cancer patients,EGFR mutation rate is 6.6 %, and all the patients with double mutations have no smoking history and most of themare young, and all the female with double mutations are adenocarcinoma.
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