临床肿瘤学杂志

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中国非小细胞肺癌患者K-Ras和EGFR基因突变与临床病理特征的关系

张洁霞,李时悦,占扬清,欧阳铭

  

  1. 510120 广州 呼吸疾病国家临床医学研究中心 广州呼吸疾病研究所
  • 收稿日期:2014-04-26 修回日期:2014-07-10 出版日期:2014-09-30 发布日期:2014-09-30
  • 通讯作者: 欧阳铭

Relationship between the mutations of K-Ras and EGFR gene and the clinicopathological features of non-small cell lung cancer

ZHANG Jiexia, LI Shiyue, ZHAN Yangqing, OUYANG Ming.   

  1. National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China
  • Received:2014-04-26 Revised:2014-07-10 Online:2014-09-30 Published:2014-09-30
  • Contact: OUYANG Ming

摘要: 目的 探讨中国非小细胞肺癌(NSCLC)患者中K-Ras和表皮生长因子受体(EGFR)基因突变情况及其与临床病理特征的关系。方法 回顾性分析2011年7月至2013年8月广州医科大学附属第一医院收治的381例NSCLC患者的临床病理特征,并应用扩增突变阻滞系统(ARMS)检测其癌组织中EGFR基因18、19、20、21外显子共21个点突变和K-Ras基因12、13密码子共6个点突变,分析其突变情况及与临床病理特征的相关性。结果 21例(5.5%)存在K-Ras基因突变,其中20例12密码子,1例13密码子Asp突变;146例(38.3%)存在EGFR突变,其中4例18外显子突变(G719S),52例19号外显子序列缺失突变,3例20外显子序列缺失突变,85例21外显子突变(81例L858R,4例L861Q),2例双突变。男性患者K-Ras基因突变率高于女性患者,差异有统计学意义(6.8% vs. 2.5%, P=0.018)。EGFR基因突变与性别、吸烟史、临床分期、全身转移、病理类型均有关(P<0.05)。二分类Logistic回归分析显示,病理类型和性别与EGFR基因突变密切相关。结论 中国NSCLC患者中EGFR突变常见,该突变与腺癌有关;K-Ras基因突变率较低,多见于男性,其他相关因素尚需进一步研究。

Abstract:

Objective To investigate the relationship between the mutations of K-Ras and epidermal growth factor receptor(EGFR) gene and K-Ras gene and clinicopathological features in Chinese patients with non-small cell lung cancer(NSCLC). Methods From July 2011 to August 2013, 381 cases of NSCLC patients with both EGFR and K-Ras mutations tested in the First Affiliated Hospital of Guangzhou Medical University were retrospectively enrolled in the study. All pathological specimens were tested for twenty-one mutations in EGFR 18-21 exon and six mutations in K-Ras 12,13 codon by amplification refractory mutation system(ARMS). The clinicopathological features of patients were analyzed according to the mutation status of EGFR and K-Ras. Results Gene mutation of K-Ras was tested in 21 cases, including 20 cases 12 codon mutation and 1 case 13 codon mutation. Gene mutation of EGFR was tested in 146 cases, including 4 cases of 18 exon G719S mutation, 52 cases of 19 exon delection mutation, 3 cases of 20 exon delection mutation, 85 cases of 21 exon mutation (81 cases of L858R and 4 case of L861Q) and two dual gene mutation. K-Ras mutation was more frequently happened in male patients than in female patients (6.8% vs. 2.5%, P=0.018). EGFR mutations were related with gender, smoking history, TNM stage, systemic metastases and pathological type(P<0.05). Binary Logistic regression shown that pathological type and gender were closely related to EGFR mutation(P<0.05). Conclusion EGFR mutation was common in Chinese patients with NSCLC, and was related to adenocarcinoma. However, K-Ras mutation was rare and more commonly happened in male patients with NSCLC. More studies should be conducted to investigate the relationship between clinical features and EGFR and K-Ras mutation.

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