中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2013年
24期
1535-1539
,共5页
张军%郑锴%张鹏%战忠利
張軍%鄭鍇%張鵬%戰忠利
장군%정개%장붕%전충리
肺腺癌%基因突变%EGFR%肺结核
肺腺癌%基因突變%EGFR%肺結覈
폐선암%기인돌변%EGFR%폐결핵
lung adenocarcinoma%mutation%EGFR%pulmonary tuberculosis
#目的：研究肺腺癌患者中表皮生长因子受体（epidermal growth factor receptor，EGFR）基因突变与肺结核在肺腺癌中的相关性。方法：采用PCR扩增及基因测序方法检测506例肺腺癌患者EGFR基因突变情况，分析其与肺结核之间的关系，进一步使用Kaplan-Meier法进行生存分析并行Log-rank检验。结果：506例肺腺癌患者中有218例患者存在EGFR突变，其中25例患者有感染肺结核病史。在肺腺癌患者中，有肺结核病史的患者EGFR基因突变率，尤其是外显子21缺失显著高于单纯肺腺癌者（P=0.047，P=0.002）。肺腺癌与结核灶在同一肺叶或同侧肺的患者EGFR基因突变率明显高于二者在不同侧肺，尤其是外显子21突变（P=0.020，P=0.030）。有肺结核病史患者的2年生存率明显高于单纯肺腺癌患者（P=0.039），且在未经EGFR-TKIs治疗的具有肺结核史的患者中，EGFR突变组与野生型组相比，2年生存率无统计学差异（P=0.948），经过EGFR-TKIs治疗的患者2年生存率亦差异无统计学意义（P=0.425）。结论：肺腺癌患者中，有肺结核病史的患者EGFR基因突变发生率明显增高，且EGFR基因突变与其预后无关。
#目的：研究肺腺癌患者中錶皮生長因子受體（epidermal growth factor receptor，EGFR）基因突變與肺結覈在肺腺癌中的相關性。方法：採用PCR擴增及基因測序方法檢測506例肺腺癌患者EGFR基因突變情況，分析其與肺結覈之間的關繫，進一步使用Kaplan-Meier法進行生存分析併行Log-rank檢驗。結果：506例肺腺癌患者中有218例患者存在EGFR突變，其中25例患者有感染肺結覈病史。在肺腺癌患者中，有肺結覈病史的患者EGFR基因突變率，尤其是外顯子21缺失顯著高于單純肺腺癌者（P=0.047，P=0.002）。肺腺癌與結覈竈在同一肺葉或同側肺的患者EGFR基因突變率明顯高于二者在不同側肺，尤其是外顯子21突變（P=0.020，P=0.030）。有肺結覈病史患者的2年生存率明顯高于單純肺腺癌患者（P=0.039），且在未經EGFR-TKIs治療的具有肺結覈史的患者中，EGFR突變組與野生型組相比，2年生存率無統計學差異（P=0.948），經過EGFR-TKIs治療的患者2年生存率亦差異無統計學意義（P=0.425）。結論：肺腺癌患者中，有肺結覈病史的患者EGFR基因突變髮生率明顯增高，且EGFR基因突變與其預後無關。
#목적：연구폐선암환자중표피생장인자수체（epidermal growth factor receptor，EGFR）기인돌변여폐결핵재폐선암중적상관성。방법：채용PCR확증급기인측서방법검측506례폐선암환자EGFR기인돌변정황，분석기여폐결핵지간적관계，진일보사용Kaplan-Meier법진행생존분석병행Log-rank검험。결과：506례폐선암환자중유218례환자존재EGFR돌변，기중25례환자유감염폐결핵병사。재폐선암환자중，유폐결핵병사적환자EGFR기인돌변솔，우기시외현자21결실현저고우단순폐선암자（P=0.047，P=0.002）。폐선암여결핵조재동일폐협혹동측폐적환자EGFR기인돌변솔명현고우이자재불동측폐，우기시외현자21돌변（P=0.020，P=0.030）。유폐결핵병사환자적2년생존솔명현고우단순폐선암환자（P=0.039），차재미경EGFR-TKIs치료적구유폐결핵사적환자중，EGFR돌변조여야생형조상비，2년생존솔무통계학차이（P=0.948），경과EGFR-TKIs치료적환자2년생존솔역차이무통계학의의（P=0.425）。결론：폐선암환자중，유폐결핵병사적환자EGFR기인돌변발생솔명현증고，차EGFR기인돌변여기예후무관。
Objective:To investigate the relationship between EGFR mutations and pulmonary tuberculosis in lung adenocarcino-ma. Methods:We detected EGFR mutations in 506 patients with lung adenocarcinoma by PCR amplification and sequencing and ana-lyzed the relationship between the mutations observed and pulmonary tuberculosis. Survival analysis was performed using the Ka-plan-Meier method with log-rank tests. Result:A total of 218 patients showed EGFR mutations;of these patients, 25 had a clinical his-tory of pulmonary tuberculosis. Compared with lung adenocarcinoma patients with no history of tuberculosis, patients with a history of pulmonary tuberculosis showed higher incidence rates of EGFR mutations, especially of exon 21 (P=0.047, P=0.002). Higher incidence rates of EGFR mutations, especially of exon 21, were observed in patients with lung cancer and tuberculosis in the same lobe or the same side of the lung than in those who had lung cancer and tuberculosis in opposite sides of the lung (P=0.02, P=0.03). Survival analy-sis showed that adenocarcinoma patients with a history of pulmonary tuberculosis have 2-year survival rates lower than that of adeno-carcinoma patients with no history of the disease (P=0.039). In patients adenocarcinoma associated with tuberculosis patients without EGFR-TKIs treatment, the 2-year survival rates of EGFR mutation patients and those without EGFR mutation showed no statistically significant difference (P=0.948). At the same time, we got the same results in adenocarcinoma associated with tuberculosis patients with EGFR-TKIs treatment (P=0.425). Conclusion:Lung adenocarcinoma patients with a history of pulmonary tuberculosis have high-er incidence rates of EGFR mutations, and EGFR mutations are not related to disease prognosis.
