Super-ARMS法检测EGFR突变在NSCLC的临床应用

目的:探讨Super-ARMS法检测体液EGFR突变在晚期非小细胞肺癌（NSCLC）患者治疗中的应用。方法:收集天津医科大学肿瘤医院自2019年4月1日—2019年12月30日161例NSCLC患者的血液、脑脊液、心包积液标本，采用Super-ARMS法对EGFR基因片段进行检测，根据突变结果对EGFR突变类型分析判断。结果:161例NSCLC患者标本中，86例（53.4％）EGFR突变阳性。19号外显子（19-del）缺失、21号外显子（L858R）基因点突变及T790M点突变最常见。S768I有5例（3.1%）；G719X突变4例（2.5％）；L861Q有1例（0.6%）；不同性别、是否吸烟者之间突变差异均无统计学意义（均P>0.05）；在年龄、是否存在EGFR-TKIs治疗史间差异均有统计学意义（均P<0.05）。EGFR基因突变率在女性、不吸烟患者中较高。结论:NSCLC患者EGFR突变率较高。Super-ARMS法可用于体液EGFR突变检测，其结果较准确，且可同时检测多种突变及并存突变。

Clinical application of EGFR mutation in NSCLC detect by the way of Super-arms

Objective: To investigate the application of Super-Arms in the detection of humoral EGFR mutation in the treatment of advanced NSCLC patients. Methods: A total of 161 patients diagnosed NSCLC between Apr 1，2019 and Dec 30，2019 were enrolled in the present study. EGFR mutations extracted from blood， cerebrospinal fluid and pericardial effusion samples were dectected using Super-ARMS. EGFR mutation was analyzed and determined according to the mutation results. Results: Of 161 NSCLC patients，86 （53.4%） were positive for EGFR mutation. Exon 19 deletion， L858R point mutation and T790M point mutation were the most common ones. S768I had 5 cases （3.1%）； 4 patients with G719X mutation （2.5%）. There was 1 case of L861Q（0.6%）. There was no statistically significant difference in mutation between different genders or smokers（all P>0.05）. There were statistically significant differences in age and history of EGFR-TKIs（all P<0.05）. EGFR mutation rate was significantly higher in female and non-smoking patients. Conclusion: NSCLC patients have higher EGFR mutation rate. Super-ARMS can be used to detect EGFR mutations in body fluids， with relatively accurate results， and can detect multiple mutations and concurrent mutations simultaneously.