CT引导下非小细胞肺癌穿刺标本检测表皮生长因子受体基因突变的临床应用

目的：探讨螺旋CT引导下经皮肺穿刺活检获得标本组织检测非小细胞肺癌（NSCLC）表皮生长因子受体（EGFR）基因突变的临床价值。方法：入组38例晚期或局部晚期无法手术的NSCLC患者，采用18G自动活检枪，经CT引导行皮肺穿刺活检获取肿瘤组织，行组织学诊断及EGFR基因检测，观察术后并发症，分析检测结果。结果：38例病例经穿刺活检均获得理想的病理标本进行组织学诊断和基因突变检测，其中腺癌患者突变率与非腺癌患者突变率差异有统计学意义；女性患者突变率与男性患者突变率差异亦有统计学意义；未发生严重并发症；EGFR基因突变患者使用吉非替尼治疗获得较好疗效。结论：CT引导的经皮肺穿刺活检技术安全有效，是晚期NSCLC获得肿瘤组织检测EGFR基因突变的可靠方法，可为临床药物分子靶向治疗提供依据。

The Clinical Application of CT-guided percutaneous lung biopsy for the detection of EGFR gene mutations in patients with advanced NSCLC

Objective：To investigate the clinical valve of spiral CT-guided percutaneous lung biopsy for the detection of epidermal growth factor receptor （EGFR）gene mutations in patients with advanced non-small cell lung cancer （NSCLC）Methods ：38 patients with inoperable advanced or locally-advanced NSCLC were enrolled in this study.By using an 18-gauge core biopsy instrument,CT-guided lung biopsy was performed in all patients to get tumor tissue for the histology diagnosis and the determination of EGFR gene mutations. Postoperative complications and histological results were analyzed. Results： Sufficient amount of tumor tissue used for the histological examination and the determination of EGFR gene mutations was successfully obtained by puncturing biopsy in all the 38 patients.The difference in the mutation rate between adenocarcinoma and non-adenocarcinoma was statistically significant.The difference in the mutation rate between female and male patients was also statistically significant.All the patients had excellent results and the patients with EGFR gene mutations tended to respond well to gefitinib.Conclusion：CT-guided 1ung biopsy is a effective and safe technique, which can be reliably used for the detection of EGFR gene mutations in patients with advanced NSCLC.Besides,this method can provide evidence for clinical targeting drug therapy.