非小细胞肺癌中EGFR和K-ras基因突变检测

目的:探讨不同类型非小细胞肺癌的EGFR和K-ras基因突变情况及其与肺癌相关临床病理特征的关系。方法:用厦门艾德ADxARMS试剂盒进行98例非小细胞肺癌患者肿瘤组织中EGFR（18,19,20,21外显子）基因和K-ras（12,13,61密码子）基因突变的检测。所有患者均未接受过吉非替尼的治疗。结果:98例样本中31例发生了EGFR基因突变,突变率为31.6%（31/98）,其中15例为19外显子缺失，13例为21 L858R外显子点突变，3例为20外显子突变，1例为18外显子突变。其中1例既有19外显子缺失突变，又有20外显子突变。腺癌中EGFR基因突变率较鳞癌、腺鳞癌、大细胞癌高。女性患者EGFR基因突变率较男性高。不吸烟患者EGFR基因突变率较吸烟患者高。低分化腺癌患者EGFR基因突变率较中、高分化患者高。21例发生了K-ras基因突变（21.4%），其中12、13、61密码子均发现突变。突变率腺癌较鳞癌、腺鳞癌、大细胞癌高，与是否吸烟、患者性别、分化程度均无相关性。结论:非小细胞肺癌患者EGFR基因突变检出率较高，K-ras基因突变率较低，且两者不存在同时突变，EGFR基因突变与肺癌组织学类型、分化程度、性别等相关。K-ras基因突变与组织学类型相关。

EGFR and K-ras gene mutation in non-small cell lung cancer

Objective:To investigate the gene mutatio of EGFR and K-ras in different types of non-small cell lung cancer,and the relationship between mutations and pathological characteristics. Methods:Gene sequencing was used to detect the EGFR(exons 18,19,20,21)and K-ras(codons 12,13,61)gene mutation status in 98 patients with non-small cell lung cancer. All patients had not recieved treament of gefitinib. Results:In 98 patients,EGFR mutation rate was 31. 6%(31/98),15 patients had No. 19 deletion mutation,13 patients had No. 21 L858R point mu-tation,3 patients had No. 20 mutation,1 patient had No. 18 mutation. 1 patient had not only No. 19 deletion mutation but also No. 20 mutation. Mutation rate was siganificantly higher in adenocarcinoma than in adeo-squmaous cacino-ma,squmaous cell cacinoma and large cell carcinoma. And was siganificantly higher in femal than in male,in non-smoking than in smoking. In adenocarcinoma,mutation rate was higher in poorly differentiated carcinoma than in me-dium and well differentiated carcinoma. K-ras mutation rate was 21. 4%(21/98),which were found in codons 12, 13 and 61. And mutation rate was higher in adenocarcinoma than in adeo-squmaous cacinoma,squmaous cell cacino-ma and large cell cacinoma. No correlation was found between K-ras mutations and the gender,the differentiation and smoking staus. Conclusion:The detection rate of EGFR mutation is higher in Chinese. The detection rate of K-ras mutation is lower in Chinese. The mutation in EGFR and K-ras does not present at the same time. The mutation in EGFR of the non-small cell lung cancer is related to gender,histology type and differentiation. The mutation in K-ras is related to histology type.