CAJ | 학술논문

目的探讨非小细胞肺癌(NSCLC)肿瘤组织表皮生长因子受体(EGFR)、KRAS和BRAF基因突变与临床病理特征的关系.方法采用基因测序的方法检测143例NSCLC患者肿瘤组织中EGFR基因第18、19、20、21外显子,KRAS基因第12、13密码子和BRAF基因第600密码子突变情况.采用SPSS 16.0软件分析各突变与临床病理特征的关系.结果 143例受检样本中,EGFR突变57例(39.9％),其中第18外显子突变2例,第19外显子突变25例,第20外显子突变3例,第21外显子突变24例,多位点突变3例;KRAS突变25例(17.5％),其中第12密码子突变23例,第13密码子突变2例;BRAF第600密码子突变2例(1.4％).未发现EGFR、KRAS和BRAF任意两者同时突变的病例.EGFR基因突变与患者的性别、吸烟史、组织学类型、分化程度和肿瘤直径具有相关性(均P＜0.05),与淋巴结转移及pTNM分期无相关性(均P＞ 0.05).KRAS基因突变与患者的性别、吸烟史、组织学类型、分化程度、肿瘤直径、淋巴结转移及pTNM分期均无相关性(均P＞0.05).结论 NSCLC患者EGFR基因突变率较高,且较常发生于女性、不吸烟、肿瘤组织较小、分化程度较患者好的腺癌组织中.KRAS基因突变率与患者性别、组织学类型等临床病理特征无关.NSCLC患者中BRAF基因突变率很低,且EGFR、KRAS和BRAF三种基因突变一般不会同时发生,为NSCLC的靶向治疗提供了客观依据.
목적 탐토비소세포폐암(NSCLC)종류조직표피생장인자수체(EGFR)、KRAS화BRAF기인돌변여림상병리특정적관계.방법 채용기인측서적방법검측143례NSCLC환자종류조직중EGFR기인제18、19、20、21외현자,KRAS기인제12、13밀마자화BRAF기인제600밀마자돌변정황.채용SPSS 16.0연건분석각돌변여림상병리특정적관계.결과 143례수검양본중,EGFR돌변57례(39.9％),기중제18외현자돌변2례,제19외현자돌변25례,제20외현자돌변3례,제21외현자돌변24례,다위점돌변3례;KRAS돌변25례(17.5％),기중제12밀마자돌변23례,제13밀마자돌변2례;BRAF제600밀마자돌변2례(1.4％).미발현EGFR、KRAS화BRAF임의량자동시돌변적병례.EGFR기인돌변여환자적성별、흡연사、조직학류형、분화정도화종류직경구유상관성(균P＜0.05),여림파결전이급pTNM분기무상관성(균P＞ 0.05).KRAS기인돌변여환자적성별、흡연사、조직학류형、분화정도、종류직경、림파결전이급pTNM분기균무상관성(균P＞0.05).결론 NSCLC환자EGFR기인돌변솔교고,차교상발생우녀성、불흡연、종류조직교소、분화정도교환자호적선암조직중.KRAS기인돌변솔여환자성별、조직학류형등림상병리특정무관.NSCLC환자중BRAF기인돌변솔흔저,차EGFR、KRAS화BRAF삼충기인돌변일반불회동시발생,위NSCLC적파향치료제공료객관의거.
Objective To investigate the epidermal growth factor receptor (EGFR),KRAS and BRAF mutations and their correlation with clinicopathological characteristics in non-small-cell lung cancer (NSCLC).Methods The mutations of exon 18,exon 19,exon 20 and exon 21 of the EGFR,codon 12,codon 13 of the KRAS and codon 600 of the BRAF gene in 143 cases of NSCLC were detected by gene sequencing.The relationship between the mutations and clinicopathological features was analyzed by SPSS 16.0.Results EGFR mutation was detected in 57 cases (39.9 ％),including 2 mutations in exon 18,25 in exon 19,3 in exon 20,24 in exon 21 and 3 multiple point mutations.KRAS mutation was found in 25 cases (17.5 ％),including 23 in codon 12 and 2 in codon 13.BRAF V600E mutation was detected only in 2 cases (1.4 ％).No patient harboring multiple EGFR,KRAS and BRAF mutations was found.EGFR mutation rate was related to gender,smoking history,histological types,differentiation and tumor size (P ＜ 0.05).However,no relationship was found among lymph node metastasis,pTNM stage and EGFR mutation (P ＞ 0.05).There was no association between KRAS mutation and clinicopathological features including gender,smoking history,histological types,differentiation,tumor size,lymph node metastasis and pTNM stage (P ＞ 0.05).Conclusions The frequency of EGFR mutation in NSCLC is high,and usually occurs in female,non-smokers,smaller tumors,better differentiation and adenocarcinomas.The frequency of KRAS mutation is not associated with the clinicolpathological features.The frequency of BRAF mutation is very low,and EGFR,KRAS and BRAF gene mutations do not occur at the same time.These results contribute to the target therapy of NSCLC.