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目的:通过免疫组织化学染色与实时荧光定量PCR检测表皮生长因子受体(EGFR)突变的比较,探讨两种检测方法的一致性及在非小细胞肺癌(NSCLC)临床检测中的应用价值。方法:随机选择36例NSCLC存档石蜡组织,采用特异性突变抗体(E746-A750del和L858R)的免疫组织化学染色方法和Roche商品化的cobas?EGFR PCR检测试剂盒检测EGFR的突变状态。结果:EGFR突变蛋白阳性定位于肿瘤细胞质和或胞膜。免疫组织化学检测显示NSCLC中EGFR突变阳性率为47.22%(17/36),其中鳞癌的突变率为9.09%(1/11),腺癌的突变率为64.00%(16/25),二者的差异有显著性(P<0.05)。实时荧光定量PCR检测NSCLC中EGFR突变阳性率为50.00%(18/36),其中鳞癌的突变率为18.18%(2/11),而腺癌的突变率为64%(16/25),二者的差异有显著性(P<0.05)。免疫组织化学染色与实时荧光定量PCR检测EGFR突变具有极好的一致性(κ=0.833,P<0.01),并且检测到的主要突变位点都是19号外显子的缺失突变(E746-A750del)和21号外显子的点突变(L858R)。结论:EGFR突变特异性抗体的免疫组织化学检测是一种可在NSCLC中进行EGFR突变筛查并对EGFR-TKI治疗快速反应的方法,具有检测费用较低、检测时间较短且结果易于判读,是一种可以在临床进行广泛推广的检测方法。EGFR突变在肺腺癌中更为常见。
OBJECTIVE: To compare the EGFR mutations detected by immunohistochemical staining and real-time fluorescence quantitative PCR and to explore the consistency of the two detection methods and their clinical value in the clinical detection of non-small cell lung cancer (NSCLC). Methods: Paraffin tissues of 36 patients with NSCLC were randomly selected. Immunohistochemical staining with specific mutant antibodies (E746-A750del and L858R) and cobas? EGFR PCR assay kit commercialized by Roche were used to detect the mutation status of EGFR. Results: EGFR mutein was localized in the cytoplasm and membrane of tumor cells. The positive rate of EGFR mutation in NSCLC was 47.22% (17/36). Immunohistochemistry showed that the mutation rate of squamous cell carcinoma was 9.09% (1/11), the rate of adenocarcinoma was 64.00% (16/25) The difference was significant (P <0.05). The positive rate of EGFR mutation in NSCLC was 50.00% (18/36) by real-time fluorescence quantitative PCR. The mutation rate of squamous cell carcinoma was 18.18% (2/11) and that of adenocarcinoma was 64% (16/25) The difference was significant (P <0.05). Immunohistochemical staining and real-time fluorescence quantitative PCR showed that EGFR mutation was highly consistent (κ = 0.833, P <0.01), and the major mutation sites detected were deletion mutation of exon 19 (E746-A750del) And point 21 exon mutation (L858R). Conclusion: Immunohistochemical detection of EGFR mutation-specific antibody is a method that can screen EGFR mutation in NSCLC and respond rapidly to EGFR-TKI therapy. It has the advantages of lower detection cost, shorter detection time and easy interpretation of the results. Is a widely used in clinical testing methods. EGFR mutations are more common in lung adenocarcinomas.