中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2008年
12期
891-896
,共6页
白桦%赵军%王书航%安彤同%王鑫%吴梅娜%段建春%杨鹭%郭庆志%刘宁红%王洁
白樺%趙軍%王書航%安彤同%王鑫%吳梅娜%段建春%楊鷺%郭慶誌%劉寧紅%王潔
백화%조군%왕서항%안동동%왕흠%오매나%단건춘%양로%곽경지%류저홍%왕길
癌,非小细胞肺%色谱法,液相%受体,表皮生长凶子%突变
癌,非小細胞肺%色譜法,液相%受體,錶皮生長兇子%突變
암,비소세포폐%색보법,액상%수체,표피생장흉자%돌변
Carcinoma,non-small-cell lung%Chromatography,liquid%Receptor,epidermal growth factor%Mutation
目的 建立变性高效液相色谱(DHPLC)法检测晚期非小细胞肺癌(NSCLC)患者外周血与肿瘤组织中表皮生长因子受体(EGFR)基因外显子19和21突变的技术平台.方法 同时收集2004年4月至2007年1月在北京肿瘤医院接受治疗的230例晚期NSCLC患者的血浆和肿瘤组织标本,采用DHPLC法检测EGFR外显子19和21突变并用测序法验证,应用x2检验分析EGFR突变与患者临床病理特征的关系,以调整比值比(OR)及95%可信区间(CJ)表示相对危险度,所有统计检验均为舣侧概率检验.分析在血浆和肿瘤组织标本中基因突变的一致性及DHPLC法与测序法的一致性.结果 230例血浆标本中EGFR突变率为34.3%(79/230),肿瘤组织中为33.5%(77/230).血浆和肿瘤组织突变阳性检出一致性为79.7%(63/79,k值为0.74).与测序法相比,DHPLC法的灵敏度和特异度分别为96.9%和91.9%(k值为0.88).肿瘤组织及外周血中EGFR突变与病理类型(OR=3.38,95%CI 1.81～6.36,P＜0.05)、吸烟史(OR=1.61,95% CI 1.13～2.28,P＜0.05)相关,而与年龄、性别、病理分期无明显相关性.结论 晚期NSCLC患者血浆EGFR突变率与肿瘤组织的突变率具有高度一致性,DHPLC法可作为EGFR突变检测的初筛方法.
目的 建立變性高效液相色譜(DHPLC)法檢測晚期非小細胞肺癌(NSCLC)患者外週血與腫瘤組織中錶皮生長因子受體(EGFR)基因外顯子19和21突變的技術平檯.方法 同時收集2004年4月至2007年1月在北京腫瘤醫院接受治療的230例晚期NSCLC患者的血漿和腫瘤組織標本,採用DHPLC法檢測EGFR外顯子19和21突變併用測序法驗證,應用x2檢驗分析EGFR突變與患者臨床病理特徵的關繫,以調整比值比(OR)及95%可信區間(CJ)錶示相對危險度,所有統計檢驗均為艤側概率檢驗.分析在血漿和腫瘤組織標本中基因突變的一緻性及DHPLC法與測序法的一緻性.結果 230例血漿標本中EGFR突變率為34.3%(79/230),腫瘤組織中為33.5%(77/230).血漿和腫瘤組織突變暘性檢齣一緻性為79.7%(63/79,k值為0.74).與測序法相比,DHPLC法的靈敏度和特異度分彆為96.9%和91.9%(k值為0.88).腫瘤組織及外週血中EGFR突變與病理類型(OR=3.38,95%CI 1.81～6.36,P＜0.05)、吸煙史(OR=1.61,95% CI 1.13～2.28,P＜0.05)相關,而與年齡、性彆、病理分期無明顯相關性.結論 晚期NSCLC患者血漿EGFR突變率與腫瘤組織的突變率具有高度一緻性,DHPLC法可作為EGFR突變檢測的初篩方法.
목적 건립변성고효액상색보(DHPLC)법검측만기비소세포폐암(NSCLC)환자외주혈여종류조직중표피생장인자수체(EGFR)기인외현자19화21돌변적기술평태.방법 동시수집2004년4월지2007년1월재북경종류의원접수치료적230례만기NSCLC환자적혈장화종류조직표본,채용DHPLC법검측EGFR외현자19화21돌변병용측서법험증,응용x2검험분석EGFR돌변여환자림상병리특정적관계,이조정비치비(OR)급95%가신구간(CJ)표시상대위험도,소유통계검험균위의측개솔검험.분석재혈장화종류조직표본중기인돌변적일치성급DHPLC법여측서법적일치성.결과 230례혈장표본중EGFR돌변솔위34.3%(79/230),종류조직중위33.5%(77/230).혈장화종류조직돌변양성검출일치성위79.7%(63/79,k치위0.74).여측서법상비,DHPLC법적령민도화특이도분별위96.9%화91.9%(k치위0.88).종류조직급외주혈중EGFR돌변여병리류형(OR=3.38,95%CI 1.81～6.36,P＜0.05)、흡연사(OR=1.61,95% CI 1.13～2.28,P＜0.05)상관,이여년령、성별、병리분기무명현상관성.결론 만기NSCLC환자혈장EGFR돌변솔여종류조직적돌변솔구유고도일치성,DHPLC법가작위EGFR돌변검측적초사방법.
Objective To study the application of denaturing high performance liquid chromatography (DHPLC) as a screening tool in detecting plasma and matched tissue epidermal growth factor receptor (EGFR) mutations for advanced non-small-cell lung cancer ( NSCLC).MethodsPlasma DNA samples and matched tumors from 230 cases of NSCLC were analyzed for EGFR mutations in exons 19 and 21 using DHPLC.The mutations in the pasma samples and the matched tumors were compared,and the association between EGFR mutations and the clinicopathological features were evaluated.Results Mutation of EGFR was found by DHPLC to be 33.5% (77/230) in tissues and 34.3% (79/230) in matched peripheral blood samples.Consistency of EGFR mutation status between tissues and matched plasma DNA was confirmed (k is 0.74,P ＜ 0.01 ).The sensitivity and specificity of DHPLC for detecting EGFR mutation were 96.9% and 91.9%,respectively(K is 0.88).EGFR mutations in both tissue and blood was correlated with histology type(OR = 3.38,95% CI 1.81-6.36,P ＜0.05 ) and smoking status( OR = 1.61,95%CI 1.13-2.28,P ＜0.05),but no association with age,sex and stage was found(P ＞0.05).Conclusion The detection of EGFR mutation is highly consistent in tissues and in plasma DNA samples.DHPLC may serve as a preliminary screening tool for detecting EGFR mutations.
