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检测非小细胞肺癌患者胸腔积液细胞块中基因突变的临床价值。

Clinical value of the detection of gene mutations in pleural effusion cell blocks among patients with non-small-cell lung cancer.

机构信息

Department of Clinical Laboratory, Jinhua Municipal Central Hospital, Jinhua, Zhejiang, China.

Pathology, Jinhua Municipal Central Hospital, Jinhua, Zhejiang, China.

出版信息

Indian J Pathol Microbiol. 2021 Jan-Mar;64(1):107-110. doi: 10.4103/IJPM.IJPM_360_20.

Abstract

OBJECTIVE

To evaluate the clinical value of epidermal growth factor receptor (EGFR) detection in pleural effusion cell blocks among patients with non-small-cell lung cancer (NSCLC).

METHODS

From July 2016 to September 2018, EGFR gene mutations in 40 lung tumor tissue samples and pleural fluid samples from NSCLC patients in Jinhua Municipal Central Hospital were assessed by the amplification refractory mutation system method. The EGFR results of the two types of samples were compared using the paired Chi-square test, and the mutation positive rates in EGFR exons 18, 19, 20 and 21 were compared between the two types of specimens using the four-grid Chi-square test.

RESULTS

Among the 40 tissue samples and pleural effusion samples, 21 and 18 cases of EGFR mutations were detected, respectively, and the mutation positive rates were 52.5% and 45%, respectively. The κ value of the consistency test of the two specimens was 0.851. There were no significant differences in the mutation positive rates in EGFR exons 18, 19, 20, and 21 between the two types of specimens.

CONCLUSION

The EGFR results of pleural fluid and tissue samples were in good agreement. Therefore, we can use pleural fluid samples to detect EGFR mutations to guide tyrosine kinase inhibitor treatment for NSCLC patients in whom tumor tissue samples cannot be obtained.

摘要

目的

评估表皮生长因子受体(EGFR)在非小细胞肺癌(NSCLC)患者胸腔积液细胞块中的临床检测价值。

方法

2016 年 7 月至 2018 年 9 月,采用扩增阻滞突变系统法检测金华市中心医院 40 例肺肿瘤组织样本和 NSCLC 患者胸腔积液样本中的 EGFR 基因突变。采用配对卡方检验比较两种样本的 EGFR 结果,采用四格卡方检验比较两种标本中 EGFR 外显子 18、19、20 和 21 的突变阳性率。

结果

40 份组织样本和胸腔积液样本中,分别检测到 21 例和 18 例 EGFR 突变,突变阳性率分别为 52.5%和 45%。两种标本一致性检验的κ 值为 0.851。两种标本 EGFR 外显子 18、19、20 和 21 的突变阳性率无显著差异。

结论

胸腔积液和组织样本的 EGFR 结果具有良好的一致性。因此,我们可以使用胸腔积液样本来检测 EGFR 突变,以指导无法获得肿瘤组织样本的 NSCLC 患者使用酪氨酸激酶抑制剂进行治疗。

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