Zhang Zhihui, Wu Xilan, Ying Jianming, Li Junling, Qiu Tian, Guo Huiqin, Zhao Huan, Shan Ling, Ling Yun
Department of Pathology, Tumor hospital Chinese Academy of Medical Sciences, Beijing 100021, China.
Department of Pathology of Medicine University of Kunming, Kunming 650031, China.
Zhongguo Fei Ai Za Zhi. 2015 Apr;18(4):199-205. doi: 10.3779/j.issn.1009-3419.2015.04.05.
Epidermal growth factor receptor (EGFR) and KRAS must be detected mutation status before patients of lung cancer use targeted drugs. The aim of this study is to elucidate the significance of EGFR and KRAS mutation in fine needle aspiration (FNA) cytology suspension specimens of non-small cell lung carcinoma.
EGFR gene exons 18-21 and KRAS codons 12, 13 of exons 2 were performed by Real-time PCR methods in fine needle aspiration cytology suspension specimens of lymph nodes.
85 metastasis lymph nodes were detected in fine needle aspiration cytology samples of lung cancer. EGFR mutation rate was 37.3%. KRAS mutation rate was 7.2%. 19 formalin fixed paraffin-embedded tissue specimens were available and match cytology specimens. Analysis of EGFR mutation status in those samples revealed agreement with the results obtained in cytological samples (kappa=1.0). Clinical follow-up was available for 13 who presented with stage IV disease. Based on the identification of such mutations, these patients received subsequent therapy with a TKI in clinic. We observed two cases complete remission (16.7%) and 8 cases partial remission (66.7%) and three had ongoing stable disease.
CONCLUSIONS: Fine-needle aspiration cytology samples were detected EGFR and KRAS mutation. The method which collects samples was easier, simple and convenient. This method has higher application value in clinical treatment. .
肺癌患者在使用靶向药物前必须检测表皮生长因子受体（EGFR）和KRAS的突变状态。本研究旨在阐明EGFR和KRAS突变在非小细胞肺癌细针穿刺（FNA）细胞学悬液标本中的意义。
采用实时荧光定量PCR方法检测淋巴结细针穿刺细胞学悬液标本中EGFR基因第18-21外显子及KRAS基因第2外显子第12、13密码子。
在肺癌细针穿刺细胞学样本中检测到85个转移淋巴结。EGFR突变率为37.3%。KRAS突变率为7.2%。有19份福尔马林固定石蜡包埋组织标本与细胞学标本匹配。对这些样本中EGFR突变状态的分析显示与细胞学样本结果一致（kappa=1.0）。13例IV期疾病患者有临床随访资料。基于此类突变的鉴定，这些患者在临床上接受了TKI后续治疗。我们观察到2例完全缓解（16.7%），8例部分缓解（66.7%），3例病情持续稳定。
细针穿刺细胞学样本检测到EGFR和KRAS突变。该样本采集方法简便易行。该方法在临床治疗中具有较高的应用价值。
