EGFR Ki-67在含微乳头结构肺腺癌中的表达及临床相关性分析

摘要

目的:探讨表皮生长因子受体(EGFR)基因突变与Ki-67蛋白在含微乳头结构(MPP)肺腺癌中表达的相关性及临床意义.方法:收集我院2013年至2017年含 MPP 肺腺癌的患者临床资料,用基因测序法检测80例患者标本的EGFR基因突变情况,并用免疫组织化学法检测 Ki67的表达.结果:80例标本中50例检测出 EGFR 突变,总检出率 62.5%,其中,EGFR基因在非吸烟、女性中突变率高;与年龄、肿瘤大小、是否转移、分期无关;Ki67蛋白表达率为63.8%,Ki67 表达与性别、年龄、吸烟史、肿瘤大小、有否淋巴结转移、分期均无相关性;EGFR 与 Ki67两者的表达呈正相关.结论:MPPAC中EGFR的突变率高于肺腺癌的其他亚型,其在女性、非吸烟、肿瘤直径≥3cm 患者中高表达. MPPAC 中Ki67的表达率高于肺腺癌的其他亚型,其在肿瘤直径≥3cm患者中高表达.在MPPAC中,EGFR基因、Ki67蛋白表达呈正相关性,两者阳性率与肿瘤大小相关,推测EGFR基因突变导致Ki67异常过表达,促进肿瘤细胞增殖.在MPP占比不同的三亚组中,EGFR基因突变率、Ki67蛋白表达阳性率与含MPP 比例均无关.%Objective: To investigate the relationship between epidermal growth factor receptor ( EGFR) gene mutation and the expression of Ki-67 protein in lung adenocarcinoma with micropapillary structure (MPP) and its clinical significance. Methods: The clinical data of MPP lung adenocarcinoma in our hospital from 2013 to 2017 were collected. The mutation of EGFR gene in 80 patients was detected by gene sequen-cing, and the expression of Ki67 was detected by immunohistochemistry.Results: Of the 80 specimens, 50 ca-ses were detected EGFR mutation, the total detection rate was 62.5%. Among them, the mutation rate of EG-FR gene was high in non smoking and female. It was not related to age, tumor size, metastasis and staging;the expression rate of Ki67 protein was 63.8%. The expression of Ki67 and sex, age, smoking history, tumor size, lymph node metastasis and staging were all. No correlation; EGFR and Ki67 expression were positively correlated. Conclusion: The mutation rate of EGFR in MPPAC is higher than that in other subtypes of lung adenocarcinoma. It is highly expressed in female, non smoking, tumor size over 3cm. The expression rate of Ki67 in MPPAC was higher than that in other subtypes of lung adenocarcinoma, and it was highly expressed in patients with tumor diameter greater than 3cm. In MPPAC, the expression of EGFR gene and Ki67 protein is positively correlated. The positive rate of both of them is related to the size of tumor. It is speculated that the mutation of EGFR gene leads to abnormal overexpression of Ki67 and promotes the proliferation of tumor cells. In the Sanya group with different MPP ratios, the EGFR gene mutation rate and the positive rate of Ki67 pro-tein expression were not related to the proportion of MPP.