EGFR在女性非小细胞肺癌中的表达及临床意义

背景与目的：近年来女性肺癌发病率的明显增加引起人们的关注.本研究主要是以女性非小细胞肺癌为研究对象,探讨表皮生长因子受体（epidermal growth fator receptor,EGFR）在女性非小细胞肺癌（non-small cell lung cancer,NSCLC）中的表达及其与女性NSCLC发生、发展及预后的关系,指导女性非小细胞肺癌的靶向治疗.方法：回顾性分析62例女性非小细胞肺癌手术病例临床病理资料及随访资料,用免疫组化的方法检测EGFR在女性非小细胞肺癌组织中的表达,对比分析10例非恶性肺组织中EGFR的表达,用Cox模型进行生存分析.结果：EGFR在62例女性NSCLC中的表达率70.97%,在非恶性肺组织中均呈阴性表达,两者比较差异有显著性（P＜0.05）;EGFR在女性腺癌的表达高于鳞癌（P＜0.05）,尤其在细支气管肺泡癌中的表达更高（P＜0.05）;EGFR表达与女性NSCLC的TNM分期及淋巴结转移呈显著正相关（P＜0.05）;EGFR高表达的女性患者生存期短、预后差（P＜0.05）;Cox比例风险模型分析表明,患者术后生存时间与病理类型、淋巴结是否转移显著相关（P＜0.05）,腺癌、有淋巴结转移是患者独立的不良预后因素.结论：女性NSCLC中EGFR的表达与患者病理类型、TNM分期及淋巴结转移有密切的关系,EGFR在女性NSCLC中高表达,可作为判断女性NSCLC病情进展及预后的重要指标,还对NSCLC女性患者的靶向治疗的选择有一定的指导意义.

Expression and clinical significance of epidermal growth factor receptor in female non-small cell lung cancer

Background and purpose:The incidence of female lung cancer has been increasing in recent years,This study emphasized the exploration of expression of epidermal growth fator receptor(EGFR) in female patients with non-small cell lung cancer(NSCLC)and its relationship between EGFR expression and the occurrence,progression and prognosis of female NSCLC,and rationalizing EGFR inhibitor as target therapy for female patients with NSCLC.Methods:The clinical and pathological characteristics of 62 cases with female NSCLC and 10 non-malignant lung tissues cases after operation have been retrospectively analyzed,and the follow-up materials also have been reviewed.The expression of EGFR was measured in 62 cases of female NSCLC and 10 non-malignant lung tissues cases as control by immunohistochemical method.Cox model has been used to calculate the survival.Results:The EGFR positive rates were 70.97% in 62 female NSCLC, negative in all non-malignant lung tissues cases.There was a notable difference between female NSCLC and non-malignant lung tissues cases(P<0.05).EGFR expression in the patients with adenocarcinoma was significantly higher than the one with squamous cell carcinoma(P<0.05),the highest expression of EGFR had been observed in the patients with bronchioloalveolar carcinoma(P<0.05).The expression of EGFR was related to TNM classification and lymph nodes metastasis(P<0.05).The female patients with higher expression of EGFR had the poorer prognosis(P<0.05).By Cox's proportional hazard model analysis,pathological types and lymph nodes metastasis were considered an independent predictor for the prognosis of the female NSCLC.Conclusions:The positive rates of EGFR expression is higher in female NSCLC than that in non-malignant lung tissues cases,The expression of EGFR have the significant relationship with some pathological characteristics such as pathological types,TNM classification and lymph nodes metastasis.EGFR may be used as a potentially useful marker for predicting the metastasis potential and prognosis of female NSCLC.EGFR inhibitor as one of target therapy should be recommended to the type of female patients with NSCLC.