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肺鳞状细胞癌中与19号和21号外显子野生型一起定义的EGFR基因7号染色体多体性和扩增。

Polysomy and amplification of chromosome 7 defined for EGFR gene in squamous cell carcinoma of the lung together with exons 19 and 21 wild type.

作者信息

Couceiro Patrícia, Sousa Vítor, Alarcão Ana, Silva Maria, Carvalho Lina

机构信息

Instituto de Patologia, Faculdade de Medicina, Universidade do Porto, Portugal.

出版信息

Rev Port Pneumol. 2010 May-Jun;16(3):453-62. doi: 10.1016/s0873-2159(15)30041-6.

Abstract

PURPOSE

The epidermal growth factor receptor (EGFR) is overexpressed in the majority of nonsmall- cell lung cancers (NSCLC) and is a major target specific EGFR tyrosine kinase inhibitors (TKIs) developed and used for the treatment of advanced NSCLC. A number of biological factors are also associated with EGFR-TKIs responsiveness. This study was focused on EGFR somatic mutations and amplifications in squamous cell lung cancer.

MATERIAL AND METHODS

Representative sections of squamous cell carcinoma were selected from 54 surgical specimens from formalin-fixed paraffin-embedded tissues and submitted to TMA construction. Determination of EGFR protein expression was done by immunohistochemistry( IHC) (Zymed, Laboratories). Fluorescence in situ hybridization (FISH) was performed with LSI EGFR/CEP 7 (Vysis; Abbott Molecular, USA). Genomic DNA was extracted from 48 cases and exon 19 was amplified by polymerase chain reaction (PCR) for search deletions and point mutations for exon 21. All cases expressed high weigh cytokeratin and were observed negativity for CK7, CD56 and chromogranin.

RESULTS

EGFR protein overexpression was identified in 49 cases, by the application of Hirsh's scoring system. The chromosome 7 and EGFR gene were analyzed by FISH and scored according to Cappuzzo's method that showed high polysomy in 31 cases and amplification in 7 cases. Deletion in exon 19 of EGFR was detected in 3 cases of 48 samples; the exon 21 of EGFR was expressed in its wild type by RFLP in all cases.

CONCLUSIONS

Detection of common EGFR deletion and mutation showed to be a rare event in Squamous cell carcinoma of the lung. While EGFR mutation is the most effective molecular predictor or sensitivity in patients with advanced NSCLC submitted to EGFR-TKIs treatment, amplification and polysomy is the most effective molecular predictor for EGFR-TKIs responsiveness in squamous cell carcinoma, when validated isolated from the group of NSCLC.

摘要

目的

表皮生长因子受体(EGFR)在大多数非小细胞肺癌(NSCLC)中过表达,是开发并用于治疗晚期NSCLC的主要靶点特异性EGFR酪氨酸激酶抑制剂(TKIs)。许多生物学因素也与EGFR-TKIs反应性相关。本研究聚焦于肺鳞状细胞癌中的EGFR体细胞突变和扩增。

材料与方法

从54例福尔马林固定石蜡包埋组织的手术标本中选取肺鳞状细胞癌代表性切片,制作组织芯片(TMA)。采用免疫组织化学(IHC)(Zymed实验室)检测EGFR蛋白表达。使用LSI EGFR/CEP 7(Vysis;美国雅培分子公司)进行荧光原位杂交(FISH)。从48例病例中提取基因组DNA,通过聚合酶链反应(PCR)扩增外显子19,以寻找外显子21的缺失和点突变。所有病例均表达高分子量细胞角蛋白,且CK7、CD56和嗜铬粒蛋白呈阴性。

结果

应用Hirsh评分系统,在49例病例中鉴定出EGFR蛋白过表达。采用FISH分析7号染色体和EGFR基因,并根据Cappuzzo方法进行评分,结果显示31例为高多体性,7例为扩增。在48个样本中的3例中检测到EGFR外显子19缺失;所有病例通过限制性片段长度多态性(RFLP)检测EGFR外显子21均为野生型表达。

结论

在肺鳞状细胞癌中,常见EGFR缺失和突变的检测结果显示为罕见事件。虽然EGFR突变是接受EGFR-TKIs治疗的晚期NSCLC患者中最有效的分子预测指标或敏感性指标,但当从NSCLC组中单独验证时,扩增和多体性是肺鳞状细胞癌中EGFR-TKIs反应性最有效的分子预测指标。

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