表皮生长因子受体在食管癌中的表达及临床意义

目的探讨表皮生长因子受体(epidermal growth factor receptor,EGFR)与食管癌临床病理特征及预后的关系。方法采用免疫组织化学法检测92份食管癌组织,26份Ⅰ度不典型增生组织,17份Ⅱ/Ⅲ度不典型增生组织,89份正常食管黏膜组织(正常组)的EGFR表达情况,并分析EGFR与临床组织病理特征及预后的关系。结果正常组、Ⅰ度不典型增生组、Ⅱ/Ⅲ度不典型增生组、食管癌组中EGFR过表达率分别为0(0/89),19.23%(5/26),58.82%(10/17),69.57%(64/92);EGFR过表达在不同浸润深度,是否伴淋巴结转移上差异均有统计学意义(P<0.05);EGFR过表达阳性组与阴性组生存曲线差异有统计学意义(P<0.05)。结论 EGFR过表达与食管癌发生、发展及预后密切相关。     

肺癌EGFR的表达及意义

目的　探讨EGFR在肺癌中的表达及与癌组织分型、淋巴结转移等方面的关系。方法　应用免疫组化S P法分别对 86例肺癌组织、35例正常肺组织EGFR的表达进行检测。结果　肺癌组织EGFR的表达明显高于正常肺组织。EGFR在鳞癌与腺癌中的表达无显著差异。淋巴结转移阳性癌组织EGFR表达与淋巴结转移阴性癌组织比较 ,无明显差别。结论　EGFR参与了肺癌的发生发展。EGFR表达与鳞癌、腺癌分型无关 ,与淋巴结转移与否无关。     

Transformation of non-small cell lung cancer into small cell lung cancer in a patient with advanced lung cancer: a case report

Targeted therapy in patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) often fails because of drug resistance. Here, we report a 57-year-old male patient with stage IV small cell lung cancer (SCLC) transformation during targeted therapy. Chest computerized tomography (CT), hematoxylin and eosin histological examination, immunohistochemistry, allele refractory mutation system‐based quantitative polymerase chain reaction analysis of EGFR point mutations, and next-generation sequencing were performed for diagnosis and therapeutic efficacy evaluation. A combination of chest CT, histological examination, and immunohistochemistry confirmed the initial NSCLC diagnosis. Next-generation sequencing detected only EGFR exon 19 deletion (ex19del) before treatment and later identified EGFR exon20p.T790M point mutation, EGFR amplification, myc proto-oncogene (MYC) amplification, retinoblastoma 1 (RB1) mutation, and tumor protein 53 (TP53) mutation. Histology and immunohistochemistry revealed transformation from NSCLC to SCLC during treatment, which eventually returned to NSCLC. Drug resistance to targeted therapy for patients with NSCLC frequently occurs because of EGFR exon20p.T790M point mutation, TP53 mutation, RB1 mutation, and MYC amplification. These mutations are also the major determining factors of NSCLC outcomes. Therefore, next-generation sequencing should be performed to confirm drug efficacy during targeted therapy for NSCLC.     

150例青海地区非小细胞肺癌患者表皮生长因子受体突变状态分析

目的探讨青海地区非小细胞肺癌(NSCLC)治疗过程中表皮生长因子受体(EGFR)突变状态。方法利用实时荧光Taqman探针法,采用PCR体外扩增,回顾性分析150例晚期NSCLC患者的临床特征、EGFR突变状态。结果 150例NSCLC患者标本检测发现EGFR(exon18)突变2例,突变率1.3%;EGFR(exon19)突变18例,突变率12.0%;EGFR(exon20)未检测出;EGFR(exon21)突变27例,突变率18.0%。结论青海地区NSCLC患者EGFR基因外显子19和21的突变(体细胞突变)率较高,可接受EGFR-TKIs治疗。     

肺癌中EGFR、VEGF与NET-1的表达及与临床病理因素的关系

目的探讨表皮生长因子受体(EGFR)、血管内皮生长因子(VEGF)、NET-1在肺癌中的表达及其与临床病理因素的关系。方法采用免疫组织化学SP法,检测120例肺癌组织及10例正常肺组织(对照组)中EGFR、VEGF、NET-1的表达。结果 EGFR、VEGF、NET-1在肺癌中的阳性表达率(69.16%、55.83%、85.00%)明显高于正常肺组织(10.00%、0.00%、40.00%)。EGFR、VEGF、NET-1蛋白在肺癌中的表达差异与患者性别、年龄、病变部位无关(P均>0.05),但与肺癌组织的分化程度、临床分期、有无淋巴结转移相关(P<0.05)。结论 EGFR、VEGF、NET-1的阳性表达与肺癌的分化程度、临床分期、淋巴结转移有关,且在癌组织中表达强度显著高于正常组织,提示三者具有促进肿瘤细胞转化、增殖、迁移的作用,可作为临床判定肺癌恶性程度及评估预后的指标。     

非小细胞肺癌表皮生长因子受体基因突变和EML4-ALK融合基因表达的研究

目的研究广西地区非小细胞肺癌(NSCLC)表皮生长因子受体(EGFR)基因突变和棘皮动物微管相关类蛋白4与间变性淋巴瘤激酶(EML4-ALK)融合基因表达的情况。方法分别采用扩增耐突变系统(ARMS-PCR)法和实时荧光定量PCR扩增检测119例NSCLC患者EGFR基因外显子18~21的突变和9种EML4-ALK融合突变体,同时分析其与临床病理特征的关系。结果 119例NSCLC患者共检出44例EGFR基因突变,检出率为37.0%,检出7例EML4-ALK融合基因阳性表达,检出率为5.9%。其中EGFR基因突变主要见于腺癌、女性、不吸烟患者;EML4-ALK融合基因表达可能与不吸烟有关,而在性别、年龄、肿瘤病理类型、淋巴转移方面比较,差异无统计学意义(P0.05);EGFR基因突变与EML4-ALK融合基因不共存。结论广西地区NSCLC患者的EGFR基因突变率与EML4-ALK融合基因阳性表达率与中国其他地区总体水平接近,均具有一定临床病理特征。     

结直肠癌TP53相关外泌体的差异蛋白分析

目的 比较分析T P53突变、敲除及野生的结直肠癌细胞分泌外泌体的蛋白质组差异.方法 从TP53野生型[HCT116-p53(WT)]、敲除型[HCT116-p53(-/-)]和构建的273位点突变型的结直肠癌HCT116细胞[HCT116-p53(R273H)]培养上清中分别提取外泌体,通过透射电镜观察其形态和免疫印...     

Expression and prognostic significance of m6A‐related genes in TP53‐mutant non‐small‐cell lung cancer

BackgroundTP53 is an important tumor suppressor gene on human 17th chromosome with its mutations more than 60% in tumor cells. Lung cancer is the highest incidence malignancy in men around the world. N‐6 methylase (m6A) is an enzyme that plays an important role in mRNA splicing, translation, and stabilization. However, its role in TP53‐mutant non‐small‐cell lung cancer (NSCLC) remains unknown.MethodFirst, we investigated 17 common m6A regulators'' prognostic values in NSCLC. Then, after the establishment of risk signature, we explored the diagnostic value of m6A in TP53‐mutant NSCLC. Finally, gene set enrichment analysis (GSEA), gene ontology (GO) enrichment analysis, and differential expression analysis were used to reveal the possible mechanism of m6A regulators affecting TP53‐mutant NSCLC patients.ResultsStudy showed that nine m6A regulators (YTHDC2, METTL14, FTO, METTL16, YTHDF1, HNRNPA2B1, RBM15, KIAA1429, and WTAP) were expressed differently between TP53‐mutant and wild‐type NSCLC (p < 0.05); and ALKBH5 and HNRNPA2B1 were associated with the prognostic of TP53‐mutant patients. After construction of the risk signature combined ALKBH5 and HNRNPA2B1, we divided patients with TP53 mutations into high‐ and low‐risk groups, and there was a significant survival difference between two groups. Finally, 338 differentially expression genes (DEGs) were found between high‐ and low‐risk groups. GO enrichment analysis, PPI network, and GSEA enrichment analysis showed that m6A may affect the immune environment in extracellular and change the stability of mRNA.ConclusionIn conclusion, m6A regulators can be used as prognostic predictors in TP53‐mutant patients.     

Role of circulating tumor cells in diagnosis of lung cancer: a systematic review and meta-analysis

ObjectiveWe systematically reviewed the literature relating to the diagnostic accuracy of circulating tumor cells (CTCs) for the clinical determination of lung cancer.MethodsThis meta-analysis aimed to evaluate the diagnostic accuracy of CTCs for the clinical determination of lung cancer. The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant studies up to 31 May 2020. The numbers of patients with true positive, false positive, false negative, and true negative results were extracted from each individual study. Pooled sensitivity, specificity, and area under the curve values were calculated with 95% confidence intervals (CI).ResultsTwenty-one studies with 3997 subjects met the inclusion criteria. The overall diagnostic accuracy was assessed. The pooled sensitivity and specificity were 0.72 (95%CI: 0.65–0.79) and 0.96 (95%CI: 0.91–0.98), respectively, and the pooled positive and negative likelihood ratios were 16.86 (95%CI: 7.65–37.12) and 0.29 (95%CI: 0.23–0.37), respectively. The combined diagnostic odds ratio was 58.12 (95%CI: 24.82–136.09).ConclusionThis meta-analysis indicated that CTCs had good diagnostic value for detecting lung cancer.     

宁夏某医院225例非小细胞肺癌患者EGFR基因突变检测结果分析

目的分析宁夏某医院非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)基因突变检测结果。方法选择2014年1月至2017年12月在宁夏医科大学总医院住院的NSCLC患者225例进行回顾性分析,用扩增阻滞突变系统-聚合酶链反应(ARMS-PCR)检测EGFR基因突变情况。结果 EGFR基因总突变率50.22%(113/225),最常见突变位点为19外显子19-del及21外显子L858R,突变率分别为21.33%及17.78%,20外显子T790M耐药突变率及20-Ins插入突变(非敏感突变)的突变率分别为3.56%及1.33%;EGFR各外显子双突变共10例;EGFR基因突变率在性别、年龄、民族、季节、标本类型之间差异无统计学意义(P>0.05),在年份、病理类型之间差异有统计学意义(P<0.05)。结论 ARMS-PCR可有效应用于临床病理石蜡标本基因突变检测,EGFR基因在19和21外显子存在较高的突变率,其突变亚型能指导小分子表皮生长因子酪氨酸酶抑制剂(EGFR-TKI)的肿瘤靶向治疗。     

EGFR在大鼠呼吸机肺损伤中的作用研究

目的研究呼吸机所致肺损伤中表皮生长因子受体(EGFR)的激活作用。方法 24只清洁级雄性SD大鼠按照是否AG1478处理和是否机械通气将其分为DMSO自主呼吸组(n=6)、DMSO机械通气组(n=6)、AG1478 10mg/kg处理自主呼吸组(n=3)、AG1478 50mg/kg处理自主呼吸组(n=3)、AG1478 10mg/kg处理机械通气组(n=3)和AG1478 50mg/kg处理机械通气组(n=3)。20%乌拉坦腹腔注射麻醉大鼠;自主呼吸的大鼠不作处理,机械通气的大鼠接小动物呼吸机行机械通气,机械通气参数设置为潮气量(Vt)20ml/kg,呼吸频率40次/min,吸呼比(I∶E)为1∶2,呼气末正压通气(PEEP)为0,吸入气体为室内空气。皮下切开行股静脉穿刺置管,监测动脉血压、心率等。4h后处死,分别收集肺组织、肺灌洗液标本。结果 AG1478 50mg/kg处理机械通气组与DMSO机械通气组相比蛋白渗漏更低,而且比AG1478 10mg/kg机械通气更低,差异均有统计学意义(P<0.05);细胞数量分析显示,AG147850mg/kg处理机械通气组与DMSO机械通气组相比中性粒细胞更低,而且比AG1478 10mg/kg处理自主呼吸组更低,差异均有统计学意义(P<0.01);AG1478 50mg/kg处理的大鼠巨噬细胞数量显著升高,均高于其他处理手段的大鼠。同样行机械通气的大鼠,AG1478组的肺血管渗漏水平与DMSO组相比更低。结论呼吸机相关肺损伤中,EGFR路径调节呼吸机诱导的肺损伤和与之相关的炎性反应,EGFR具有活化信号的作用,可调节呼吸机诱导的肺血管渗漏。     

The potential diagnosis role of TP53 mutation in advanced bladder cancer: A meta‐analysis

BackgroundBladder cancer is one of the most common urological cancers all over the world, and NMIBC occupies almost 80% of recently diagnosed bladder cancer cases. Progress and recurrence of bladder cancer are the main problems during the disease. The level of TP53 mutation is obviously higher in the high stage than the lower. This meta‐analysis is to evaluate the potential diagnosis feature of TP53 mutation by the expression of TP53 mutation of Ta stage vs high stage in bladder cancer.MethodsA systematic search of databases was conducted, and some relevant articles were selected. Next, the meta‐analysis was carried out according to the standard guidelines.ResultsThere were seven researches in which 677 participants were selected at the basis of inclusion standard. TP53 mutation was associated highly with increased diagnosis of bladder cancer. We found that the high stage of bladder cancer has obviously higher level of TP53 mutation than the lower stage, and these patients of MIBC have higher expression of TP53 mutation compared with NMIBC. No significant publication bias has been observed in this meta‐analysis. The expression of TP53 mutation might be a diagnose‐related biomarker for lots of patients with bladder cancer.ConclusionsThe results of this meta‐analysis provided further evidences that the expression of TP53 mutation was associated with the diagnosis efficiency of advanced bladder cancer. Higher expression of TP53 mutation was observed in the high stage of bladder cancer or the MIBC, and lower expression of TP53 mutation in the Ta stage of bladder cancer or the NMIBC. The expression level of TP53 mutation was probably a critical diagnosed biomarker in advanced bladder cancer.     

Adx-ARMS法与PCR-Sanger测序法检测非小细胞肺癌微小标本EGFR基因突变的比较

目的比较ADx-ARMS法和PCR-Sanger测序法检测肺癌微小标本EGFR基因突变的差异,评价微小标本用于非小细胞肺癌(NSCLC)患者EGFR突变检测的临床应用价值。方法收集2012~2013年95例NSCLC患者98份微小标本;用ADxARMS法和PCR-Sanger测序法检测上述标本EGFR基因18、19、20、21外显子基因突变,分析其与患者临床、病理特征的关联性。结果 ADx-ARMS法突变总检出率为51.0%(50/98),PCR-Sanger测序法突变总检出率为25.3%(24/95)。突变多见于女性(65.1%)、非吸烟(64.0%)、腺癌(51.9%)患者。EGFR-TKI疗效研究结果表明,ADx-ARMS法和PCR-Sanger测序法检测结果均为野生型患者的无进展生存期(PFS)为2.0个月,明显短于两种方法检测均为突变型和仅ADx-ARMS法检测为突变型患者的9.1个月和10.0个月(P0.01)。结论对于难以获得手术切除标本的患者,微小标本可作为其进行EGFR突变检测的适用材料;ADx-ARMS法较PCR-Sanger测序法更适用于微小标本的基因检测。     

乳腺癌患者手术前后相关实验室数据的检测意义

目的探讨乳腺癌患者手术前后可溶性细胞膜糖蛋白(Endoglin)、血管内皮生长因子(VEGF)、表皮生长因子受体(EGFR)的水平变化,分析可溶性Endoglin、VEGF和EGFR水平检测在乳腺癌患者中的临床意义。方法选取2016年10月至2018年9月在该院进行手术的乳腺癌患者52例作为观察组,以同期健康体检者50例作为对照组,分别检测观察组手术前后和对照组可溶性Endoglin、VEGF和EGFR水平,并对数据进行比较分析。结果观察组患者手术前可溶性Endoglin、VEGF和EGFR表达水平均明显高于对照组,差异均有统计学意义(P<0.05);观察组患者手术前可溶性Endoglin、VEGF和EGFR表达水平均明显高于手术后,差异均有统计学意义(P<0.05);观察组患者手术后可溶性Endoglin、VEGF和EGFR表达水平与对照组比较,差异均无统计学意义(P>0.05)。结论在乳腺癌患者中,存在可溶性Endoglin、VEGF和EGFR表达水平异常,可溶性Endoglin、VEGF和EGFR水平检测对乳腺癌患者手术前后的病情观察及预后有一定临床应用价值。     

液滴式数字PCR检测晚期非小细胞肺癌血液EGFR突变的应用价值

目的采用液滴式数字PCR(ddPCR)法检测晚期非小细胞肺癌(NSCLC)患者外周血循环肿瘤DNA(ctDNA)EGFR基因突变的情况,探讨试剂盒的性能、检测结果的可靠性和准确性以及ddPCR法在外周血ctDNA中的应用价值。方法使用标准突变比例的模拟cfDNA样本ddPCR法对试剂检测限、准确性、特异性、精密度、抗干扰能力等指标进行分析及评价;使用ddPCR法检测262例NSCLC患者外周血ctDNA,随机选取30例样本同时进行Super-ARMS法检测,并从方法学标准化和检测结果准确性两方面进行统计学分析。结果检测试剂在检测限以上的准确性、特异性均为100%,定量精密度(突变比例对数的绝对值变异系数CV)5%,关键环节质量控制各主要参数的相关性和线性关系均符合要求;Super-ARMS和ddPCR法同步检测30例NSCLC患者外周血ctDNA的结果具有较好的一致性(Kappa=0.783,P=0.000)。结论 ddPCR法灵敏度高,可绝对定量,是血液检测的有效的方法,但其在检测过程中存在较多对检测结果产生影响的环节,故而检测方法标准化至关重要。     

Platelet/lymphocyte ratio is a significant prognostic factor for targeted therapy in patients with EGFR-mutated non-small-cell lung cancer

ObjectiveTo analyze the prognostic significance of the pretreatment platelet/lymphocyte ratio (PLR) for targeted therapy in patients with epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC).MethodsWe conducted a retrospective study of 96 patients with EGFR-mutated advanced NSCLC who were treated at Dongguan People’s Hospital, Southern Medical University from May 2014 to December 2017. All patients received EGFR-targeted therapy until disease progression, unacceptable toxicity, or other factors. Approximately 3 days before the initial treatment, data including a detailed clinical history, physical examination, radiographic results, pathological diagnosis, and laboratory parameters including complete blood cell counts and albumin levels were evaluated.ResultsPatients in the PLR ≥ 190 group had shorter progression-free survival (PFS) than those in the PLR < 190 group. Furthermore, the 1-year PFS rate was worse in the PLR ≥ 190 group than in the PLR< 190 group. Multivariate analysis indicated the possible role of PLR as a prognostic factor for patients with advanced NSCLC who received EGFR-targeted therapy.ConclusionsPretreatment PLR may be an independent prognostic factor for patients with NSCLC receiving EGFR tyrosine kinase inhibitor treatment. Further studies are needed to identify the impact of PLR on EGFR-mutated NSCLC.     

Association between squamous cell carcinoma antigen level and EGFR mutation status in Chinese lung adenocarcinoma patients

BackgroundTo investigate the association between squamous cell carcinoma antigen (SCCAg) level and epidermal growth factor receptor (EGFR) mutation status in Chinese lung adenocarcinoma patients.MethodsWe retrospectively analyzed 293 patients with lung adenocarcinoma, divided into EGFR mutant group (n = 178) and EGFR wild‐type group (n = 115). The general data and laboratory parameters of the two groups were compared. We used univariable and multivariable logistic regression to analyze the association between SCCAg level and EGFR mutation. Generalized additive model was used for curve fitting, and a hierarchical binary logistic regression model was used for interaction analysis.ResultsSquamous cell carcinoma antigen level in the EGFR wild‐type group was significantly higher than that in the mutant group (p < 0.001). After adjusting for confounding factors, we found that elevated SCCAg was associated with a lower probability of EGFR mutation, with an OR of 0.717 (95% CI: 0.543–0.947, p = 0.019). For the tripartite SCCAg groups, the increasing trend of SCCAg was significantly associated with the decreasing probability of EGFR mutation (p for trend = 0.015), especially for Tertile 3 versus Tertile 1 (OR = 0.505; 95% CI: 0.258–0.986; p = 0.045). Curve fitting showed that there was an approximate linear negative relationship between continuous SCCAg and EGFR mutation probability (p = 0.020), which was first flattened and then decreased (p < 0.001). The association between the two was consistent among different subgroups, suggesting no interaction (all p > 0.05).ConclusionThere is a negative association between SCCAg level and EGFR mutation probability in Chinese lung adenocarcinoma patients.     

EGFR和PDGFR在慢性前列腺炎中的表达及其意义

目的检测Wistar大鼠慢性前列腺炎动物模型的表皮生长因子受体（EGFR）和血小板衍生的生长因子受体（PDGFRl的表达,为慢性前列腺芡和前列腺癌的的关联性提供理论依据。方法实验组和对照组各采用50只Wistar大鼠慢性细菌性前列腺炎组织和正常前列腺组织．应用免疫组化方法分别检测两组大鼠前列腺组织的EGFR和PDGFR的表达情况。结果实验组大鼠慢性前列腺炎组织EGFR和PDGFR表达均较对照组明显增加,差异均有统计学意义（u分别=3．35、9．05,P均〈0．05）。结论慢性细菌性前列腺炎组织中EGFR和PDGFR的表达高于正常组织,可能与前列腺癌存在一定关联。     

EGFR mutations in non-small cell lung cancer: an audit from West China Hospital

Objectives: To discover the incidence and characteristics of EGFR mutations in non-small cell lung cancer (NSCLC) in a single, large cohort as a part of routine diagnostic investigations.

Methods: We reviewed EGFR mutations investigated by Amplification Refractory Mutation System (ARMS) PCR (covering 29 known mutations) using DNA samples from FFPE tissue or cell clot specimens in a total of 3894 cases of NSCLC analysed between 2012-2014.

Results: EGFR mutations are preferentially associated with adenocarcinomaand adenosquamous histology, particularly those well to moderately differentiated, and were significantly more common in female than male patients irrespective of histological subtypes. Exon 19 deletion (45.7%) and exon 21 L858R (45.6%) accounted for the vast majority of the EGFR mutations detected, with the remaining mutations being infrequent (<2%). Compound mutations were seen in 51 (3%) of the mutant cases, the combination of these compound mutations could be classified into three subgroups according to the potential impact of individual mutations on EGFR TKI therapy. Accordingly, 7 cases had both sensitive mutations, 4 cases harboured one sensitive and one less responsive /uncertain mutation, 19 cases contained one sensitive and one resistant change, and a further 21 cases had two less responsive /uncertain mutations.

Conclusion: Our data represents the largest EGFR mutation survey based on routine clinical diagnostic laboratory data from a single institution, it confirms the incidence and characteristics of EGFR mutations in NSCLC seen in Asian patients, and also unravels the combinatorial nature of rare compound EGFR mutations.