摘要
目的研究CT引导经皮肺穿刺活检获得组织检测非小细胞肺癌(NSCLC)表皮生长因子受体(EGFR)基因突变的可行性。方法入组40例晚期或局部晚期无法手术的NSCLC患者,采用18 G自动活检枪,经CT引导行肺穿刺活检获取肿瘤组织,行EGFR基因检测,观察术后并发症,分析检测结果。结果 40例病例均经穿刺活检获得足够的病变组织进行组织学诊断和基因突变检测,EGFR基因突变率为37.5%(15/40),其中腺癌患者突变率为50.0%(12/24),非腺癌患者突变率为18.8%(3/16),两者间差异有统计学意义;3例患者穿刺后出现气胸,3例患者出现咯血;无血胸、纵隔气肿、感染及针道种植等并发症;EGFR基因突变患者使用吉非替尼治疗获得良好疗效。结论 CT引导的经皮肺穿刺活检技术简便、安全,是晚期NSCLC获得肿瘤组织检测EGFR基因突变的可靠方法,能够用于预测晚期NSCLC的靶向治疗效果。
Objective To investigate the feasibility of CT-guided percutaneous lung biopsy for the detection of epidermal growth factor receptor （EGFR） gene mutations in patients with advanced non-small cell lung cancer （NSCLC）. Methods Forty patients with inoperable advanced or locally-advanced NSCLC were enrolled in this study. By using an 18-gauge core biopsy instrument, CT-guided lung biopsy was performed in all patients to get tumor tissue for the determination of EGFR gene mutations. Postoperative complications and histological results were analyzed. Results Sufficient amount of tumor tissue used for the histological examination and the determination of EGFR gene mutations was successfully obtained by puncturing biopsy in all the forty patients. EGFR mutations occurred in 37.5% of all NSCLC cases （15/40）. The mutation rate in adenocarcinoma was 50% （12/24）, while the mutation rate in non-adenocarcinoma was only 18.8% （12/24）, the difference in the mutation rate between the two pathologic types was statistically significant （P = 0.046）. Three patients developed pneumothorax. Hemoptysis occurred in three patients. No hemothorax, mediastinal emphysema, infection or needle tract seeding occurred. The patients with EGFR gene mutations tended to respond well to gefitinib. Conclusion CT-guided lung biopsy is a simple and safe technique, which can be reliably used for the detection of EGFR gene mutations in patients with advanced NSCLC. Besides, this method is also very helpful in predicting the clinic efficacy of targeted therapy for advanced NSCLC.
出处
《介入放射学杂志》
CSCD
北大核心
2013年第2期125-128,共4页
Journal of Interventional Radiology
关键词
非小细胞肺癌
CT引导经皮肺穿刺活检
EGFR基因突变
non-small cell lung cancer
CT-guided percutaneous lung biopsy
epidermal growth factor receptor gene mutation
