摘要
目的探讨CT引导经皮肺穿刺活检标本组织检测非小细胞肺癌（NSCLC）表皮生长因子受体（EGFR）基因突变的临床价值。方法自2011年4月至2015年6月168例临床诊断晚期无法手术NSCLC患者，在CT引导下行肺穿刺活检获取肿瘤组织标本，进行组织学诊断和EGFR基因检测，并分析检测结果。结果168例患者均穿刺获得足够标本，进行组织学诊断和EGFR基因检测。肺癌诊断率为80．36％（135／168），其中腺癌占48．15％（65／135），鳞状细胞癌占33．33％（45／135），小细胞癌占15．56％（21／135），其它2．96％（4／135）。腺癌基因突变率为50．77％（33／65），非腺癌基因突变率为12．86％（9／70），两者差异有统计学意义（P〈0．05）。男性患者EGFR基因突变率为17．28％（14／81），女性患者EGFR基因突变率为51．85％（28／54），两组差异有统计学意义（P〈0．05）。全组患者未出现严重并发症。EGFR基因突变患者经色GFR抑制剂治疗临床获益明显。结论CT引导经皮肺穿刺活检安全有效，不但能获得组织病理诊断，也是检测EGFR基因突变的可靠方法，为指导临床用药提供依据。
Objective To explore the clinical value of detecting of epidermal growth factor receptor gene mutation by CT guided percutaneous lung puncture biopsy in non-small cell lung cancer. Methods From April 2011 to June 2015, sample of 168 cases of advanced inoperable non small cell lung cancer patients were obtained by CT guided needle biopsy of lung tumor tissue with for histological diagnosis and EGFR gene detection, and the results were analyzed. Results 168 patients were punctured to obtain enough samples for histological diagnosis and detection of EGFR gene detection were performed. The rate of diagnosis of lung cancer was 80.36% （ 135/168 ） , The adenocarcinoma accounted for 48.15% （ 65/135 ） , squamous cell carcinoma accounted for 33.33% （ 45/135 ） , small cell carcinoma accounted for 15.56% （ 21/135 ） , the other accounted for 2.96% （ 4/135 ） . Adenocarcinoma gene mutation rate was 50.77% （ 33/65 ） , non adenocarcinoma gene mutation rate was 12.86% （ 9/70 ） , both of them have significant difference （P〈0.05） . Male patients with EGFR gene mutation rate was 17.28% （ 14/81 ） , female patients with EGFR gene mutation rate was 51.85% （ 28/54 ） , the two groups had significant difference （ P〈0.05 ） .All patients had no serious complications. The patients with EGFR gene mutation treated by epidermal growth factor receptor inhibitors had clinically significant benefits. Conclusions CT guided percutaneous lung puncture biopsy is safe and effective, not only can obtain the pathological diagnosis, and reliable detection method for EGFR gene mutation, provide the basis for clinical medication.
出处
《浙江临床医学》
2017年第2期203-204,共2页
Zhejiang Clinical Medical Journal
基金
浙江省衢州市科技计划项目资助（20111092）
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 （ NSCLC ） CT guided percutaneous lung puncture biopsy EGFR gene mutation
