摘要
目的探讨酶切富集联合变性高效液相色谱法（REDE-DHPLC）检测非小细胞肺癌（NSCLC）患者外周血表皮生长因子受体（EGFR）突变的临床应用价值。方法采用REDE-DHPLC法对该院收治的403例NSCLC患者血浆EGFR19和21外显子突变状态进行检测，分析突变与基线资料的相关性。其中115例患者同时采用ARMS法对肿瘤组织样本进行突变检测，比较两种方法检测的一致性。结果403例患者血浆样本总突变率为26．3％（106／403）。女性、不吸烟、腺癌及晚期（Ⅲb～Ⅳ）患者血浆EGFR突变率分别显著高于男性、吸烟、非腺癌及早期患者（P〈0．05）。多变量Logistic分析显示性别、吸烟史及组织类型是血浆EGFR突变的独立预测因素（P〈0．05）。115例配对样本中，以组织样本为标准，REDE—DHPLC法检测血浆EGFR突变的敏感度、特异度、阳性预测值、阴性预测值分别为69．0％、97．3％、93．5％、84．5％，两种检测方法具有较好的一致性（k=0．702）。结论性别、吸烟史及组织类型是NSCLC患者血浆EGFR突变的独立预测因素，REDE—DHPLC法检测血浆EGFR突变敏感度及特异度较高。
Objective To investigate the clinical application value of peripheral blood epidermal growth factor receptor （EG- FR） mutations in non-small cell lung cancer （NSCLC） detected by the restriction endonuclease digestion combine with denaturing high performance liquid chromatography （REDE-DHPLC）. Methods Four hundred and three patients with NSCLC in our depart- ment were detected plasma EGFR mutations for exons 19 and 21 by the REDE-DHPLC method. The relationships of EGFR muta- tions with the patientst clinical characteristics at baseline were analyzed. Among 403 patients, 115 cases were detected EGFR mutations in tumor tissue by simultaneously adopting the ARMS method. The consistency of the two methods was compared. Results The total activating mutation rate of EGFR was 26.3 % （106/403） in plasma. The mutation rate in female,non-smoking, adenocarcinoma and stage ⅢB-Ⅳ were significantly higher than that in men, smoking, non-adenocarcinoma and stage ⅠA-ⅢA（P〈0.05）. The multivariate Logistic analysis results showed that gender,smoking history and histological types were the independent predic- tors of EGFR mutations in plasma（P〈0.05）. In the 115 matched samples, taking the tissue samples as standards, the sensitivity, specificity, positive predictive value and negative predictive value of the REDE-DHPLC for detecting EGFR mutation were 69.0 %, 97.3 %, 93.5 % and 84.5 % respectively. The two detection methods had better consistency（s= 0. 702, P〈0.01）. Conclusion Gender,smoking history and histological types are the independent predictors of plasma EGFR mutation. REDE-DHPLC has higher sensitivity and higher specificity for detecting plasma EGFR mutation.
出处
《重庆医学》
CAS
北大核心
2016年第13期1767-1769,1772,共4页
Chongqing medicine
基金
吴阶平基金资助项目(320.6750.12228
320.6750.12177)
关键词
癌
非小细胞肺
色谱法
高压液相
酶切富集
受体
表皮生长因子
carcinoma, non-small-cell lungl chromatography, high pressure liguid
enzyme digestion enrichment
receptor, epidermal growth factor
