CAJ | 학술논문

目的：探讨表皮生长因子受体（ EGFR ）基因突变和表达对小分子酪氨酸激酶抑制剂（TKI）治疗食管癌、食管胃交界处（EGJ）癌和胃癌疗效预测的价值。方法收集经甲醛固定的食管癌、EGJ癌和胃癌石蜡包埋组织标本180例，其中食管癌39例，EGJ癌92例，胃癌49例。采用荧光PCR-优化寡核苷酸探针法检测EGFR基因第18～21外显子的29种突变情况，免疫组化法检测89例肿瘤组织中的EGFR蛋白表达。结果180例肿瘤组织中均未检测到EGFR 18～21号外显子突变。89例肿瘤组织中，EGFR（-）12例，EGFR（＋）31例，EGFR（＋＋）24例，EGFR（＋＋＋）22例。13例食管鳞癌组织中，EGFR （＋＋）或EGFR（＋＋＋）12例（92．3％）。61例EGJ癌组织中，EGFR （＋＋）或EGFR （＋＋＋）29例（47．5％）。15例胃腺癌组织中，EGFR（＋＋）或EGFR（＋＋＋）5例（33．3％）。结论180例食管癌、EGJ癌和胃癌组织中无EGFR基因18～21号外显子突变，应进行更多的研究来探索可以预测小分子TKI类药物治疗食管癌、EGJ癌和胃癌疗效的分子标志物。
목적：탐토표피생장인자수체（ EGFR ）기인돌변화표체대소분자락안산격매억제제（TKI）치료식관암、식관위교계처（EGJ）암화위암료효예측적개치。방법수집경갑철고정적식관암、EGJ암화위암석사포매조직표본180례，기중식관암39례，EGJ암92례，위암49례。채용형광PCR-우화과핵감산탐침법검측EGFR기인제18～21외현자적29충돌변정황，면역조화법검측89례종류조직중적EGFR단백표체。결과180례종류조직중균미검측도EGFR 18～21호외현자돌변。89례종류조직중，EGFR（-）12례，EGFR（＋）31례，EGFR（＋＋）24례，EGFR（＋＋＋）22례。13례식관린암조직중，EGFR （＋＋）혹EGFR（＋＋＋）12례（92．3％）。61례EGJ암조직중，EGFR （＋＋）혹EGFR （＋＋＋）29례（47．5％）。15례위선암조직중，EGFR（＋＋）혹EGFR（＋＋＋）5례（33．3％）。결론180례식관암、EGJ암화위암조직중무EGFR기인18～21호외현자돌변，응진행경다적연구래탐색가이예측소분자TKI류약물치료식관암、EGJ암화위암료효적분자표지물。
Objective Tyrosine kinase inhibitors ( TKIs) of the epidermal growth factor receptor ( EGFR) have been reported to be effective in the treatment of esophageal and esophagogastric junction cancers.The aim of this study was to detect the frequency of EGFR mutation and expression in Chinese patients with esophageal , esophagogastric junction and gastric cancers , and to clarify the value of EGFR mutation and expression in predicting the efficacy of TKI in the treatment of these tumors .Methods In this study, 180 tumor samples with histologically confirmed esophageal cancer (39 cases), cancer of the esophagogastric junction ( 92 cases ) and gastric cancer ( 49 cases ) were collected .Twenty-nine different EGFR mutations in exons 18-21 were assessed by real-time PCR-optimized oligonucleotide probe method. EGFR protein expression was evaluated by immunohistochemistry ( IHC) in 89 tumor samples.Results The mutation analysis for EGFR ( exons 18-21) showed no mutations in any of the hotspots of the gene in the 180 tumor samples analyzed .EGFR expression was negative in 12 tumor samples, 1+in 31 tumor samples, 2+in 24 tumor samples,and 3+in 22 tumor samples.EGFR expression was 2+or 3+in 12 (92.3%)of the 13 esophageal squamous cell carcinomas , 29 (47.5%) of the 61 esophagogastric junction cancers , and 5 (33.3%) of the 15 gastric adenocarcinomas .Conclusions Our results indicate that EGFR mutation in exons 18-21 is absent in the examined samples of esophageal , esophagogastric junction and gastric cancers . More studies are warranted to explore the predictive biological markers for the therapeutic response to EGFR TKI.