CAJ | 학술논문

目的：探讨表皮生长因子受体（ epithe1ia1 growth factor receptor，EGFR）突变特异性抗体在肺腺癌中的表达及其意义。方法应用免疫组织化学（ immunohistochemistry，IHC）法检测171例已知EGFR突变情况[扩增阻滞突变系统-PCR（ amp1ification refractory mutation system-PCR，ARMS-PCR）法检测]的肺腺癌中EGFR基因19、21号外显子突变特异性蛋白（ EGFR-19、EGFR-21）和非突变蛋白（ EGFR-P）的表达，分析EGFR-19、21表达与临床病理特征的关系，检验IHC与ARMS-PCR法检测结果的一致性。结果 EGFR突变蛋白表达与低分化腺癌（微乳头型、实体型）有关（ P=0.021）；EGFR-21高表达与肿瘤侵犯胸膜有关（P=0.005）。IHC法检测EGFR-19、21表达与ARMS-PCR法检测EGFR突变具有一致性（Kappa值均>0.4）；EGFR-19、21的敏感性、特异性分别为65.0%、89.4%和70.0%、97.6%。结论肺腺癌中EGFR突变蛋白表达与组织分化差、胸膜侵犯有关，提示其可作为预后不良的指标；IHC法检测EGFR突变特异性蛋白可用作EGFR突变初筛手段。
목적：탐토표피생장인자수체（ epithe1ia1 growth factor receptor，EGFR）돌변특이성항체재폐선암중적표체급기의의。방법응용면역조직화학（ immunohistochemistry，IHC）법검측171례이지EGFR돌변정황[확증조체돌변계통-PCR（ amp1ification refractory mutation system-PCR，ARMS-PCR）법검측]적폐선암중EGFR기인19、21호외현자돌변특이성단백（ EGFR-19、EGFR-21）화비돌변단백（ EGFR-P）적표체，분석EGFR-19、21표체여림상병리특정적관계，검험IHC여ARMS-PCR법검측결과적일치성。결과 EGFR돌변단백표체여저분화선암（미유두형、실체형）유관（ P=0.021）；EGFR-21고표체여종류침범흉막유관（P=0.005）。IHC법검측EGFR-19、21표체여ARMS-PCR법검측EGFR돌변구유일치성（Kappa치균>0.4）；EGFR-19、21적민감성、특이성분별위65.0%、89.4%화70.0%、97.6%。결론폐선암중EGFR돌변단백표체여조직분화차、흉막침범유관，제시기가작위예후불량적지표；IHC법검측EGFR돌변특이성단백가용작EGFR돌변초사수단。
Purpose To investigate the expression and significance of epiderma1 growth factor receptor( EGFR)mutation-specific anti-bodies in 1ung adenocarcinoma. Methods Immunohistochemica1( IHC)technique was used to detect the expression of EGFR muta-tion-specific antibodies(EGFR-19,EGFR-21)and EGFR tota1 protein antibody(EGFR-P)in 171 cases of 1ung adenocarcinoma with resected specimens,and EGFR gene mutation was a1so performed by amp1ification refractory mutation aystem-PCR( ARMS-PCR). The expression of EGFR-19,EGFR-21 and EGFR-P mutant proteins was compared with EGFR gene mutation and their re1ationship with histo1ogica1 c1assification and c1inica1 characteristics were ana1yzed. Results The expression of EGFR mutant protein was corre1ated with the poor differentiation group inc1uding micropapi11ary and so1id predominant types( P=0. 021 ). EGFR-21 high expression was re1ated to p1eura1 invasion(P=0. 005). The coherence of IHC(with EGFR-19/21 antibodies)and ARMS-PCR was existed(Kappa>0. 4 ). Taking ARMS-PCR as a standard,the sensitivity and specificity of EGFR-19 and EGFR-21 were 65. 0% and 89. 4%, 70. 0% and 97. 6%,respective1y. Conclusions Expression of EGFR mutation-specific antibodies is associated with poor differentia-tion and p1eura1 invasion. It suggests a worse prognosis indicator in 1ung adenocarcinoma. Because of the coherence with ARMS-PCR, using IHC with mutation-specific antibodies to detect the mutant proteins of EGFR-19/21 may act as a pre1iminary screening method of EGFR gene mutation.