HRM方法检测非小细胞肺癌患者胸水标本癌细胞基因突变的临床意义

Feasibility of HRM to detect gene mutations in hydrothorax of patients with non-small cell lung cancer

关键词:  HRM  胸水标本  非小细胞肺癌

Key words:  HRM  hydrothorax samples  non-small cell lung cancer

摘要:

[目的] 探讨应用HRM方法检测非小细胞肺癌患者胸水标本癌细胞EGFR、KRAS基因突变用于指导EGFR酪氨酸激酶受体抑制剂治疗的可行性。 [方法] 收集36例非小细胞肺癌患者胸水标本，常规提取DNA，HRM方法检测KRAS基因第2外显子、EGFR基因第19和21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KRAS、EGFR突变率差异。 [结果] 胸水标本36例中，2例（5.6%）KRAS突变，10例（27.8%）EGFR突变（其中EGFR第19和21外显子突变各5例）。前期检测过的非小细胞肺癌组织KRAS和EGFR突变率分别为5.8%和36.3%。KRAS和EGFR突变率在胸水标本与前期非小细胞肺癌组织中差异均无显著性意义（P>0.05）。 [结论] 对难以获得肺癌组织标本的非小细胞肺癌患者可应用HRM方法检测胸水标本筛查KRAS、EGFR基因突变，指导EGFR酪氨酸激酶受体抑制剂应用。

Abstract:

[Objective] To explore the clinical significance of HRM to detect EGFR and KRAS gene mutations in hydrothorax of patients with non-small cell lung cancer (NSCLC) for directing EGFR tyrosine kinase inhibitor therapy. [Methods] The mutations of KRAS gene in exon 2 and EGFR gene in exon 19, 21 were detected with HRM. The frequencies of EGFR and KRAS mutations between hydrothorax samples and cancer tissue samples from patients with NSCLC were analyzed statistically. [Results] There were 2 cases (5.6%) with KRAS mutations and 10 cases (27.8%) with EGFR mutations, including 4 cases in exon 19 and 5 cases in exon 21 found in hydrothorax with HRM. The frequencies of KRAS and EGFR mutation, detected in NSCLC tissues before, were 5.8% and 36.3% separately. There was no significant difference in either KRAS or EGFR between hydrothorax and cancer tissue samples. [Conclusion] It is helpful to patients with NSCLC who have lost the operation opportunity to detect the gene mutation in hydrothorax with HRM in directing the EGFR tyrosine kinase inhibitor therapy.