Correlation of pulmonary adenocarcinoma with micropapillary pattern with EGFR and KRAS mutation and their clinicopathological features
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摘要:
目的 探讨伴微乳头成分的肺腺癌(pulmonary adenocarcinoma with a micropapillary pattern, MPPAC) EGFR、KRAS基因突变情况及其临床病理学特征。 方法 根据2011年的肺腺癌新分类诊断标准, 以是否伴有微小乳头状结构(micropapillary pat tern, MPP), 将144例肺腺癌病例分为MPP阳性组77例和MPP阴性组77例。MPP阳性组中又按MPP所占比例分为(+、++、+++) 三亚组。RT-PCR法检测两组EGFR、KRAS基因突变情况。 结果 在144例肺腺癌病例中EGFR突变62例(43.1%), KRAS突变9例(6.25%), EGFR突变与性别(P=0.018) 和肿瘤体积(P=0.016) 有关。MPP阳性组EGFR突变率高于MPP阴性组(P < 0.001);KRAS突变率低于MPP阴性组(P=0.016)。EGFR基因突变频率在MPP三亚组中无明显不同(P=0.932)。 结论 伴微乳头结构的肺腺癌EGFR突变频率高于肺腺癌其它亚型, KRAS突变频率低于肺腺癌其它亚型, 说明其有独特的分子生物学特点。 Abstract:Objective To assess the correlation of pulmonary micropapillary adenocarcinoma with epidermal growth factor receptor (EGFR) and KRAS mutation status and determine their clinicopathological features. Methods We divided 144 cases of lung adenocarcinoma into two groups according to the new diagnostic criteria for the classification of lung adenocarcinoma (published in 2011) : the micropapillary pattern (MPP) -positive group and the MPP-negative group, each with 77 cases.The MPP-positive group was further subdivided into three subgroups (+, ++, and +++) according to the proportion of the micropapillary component.EGFR and KRAS gene mutations were detected by real time PCR polymerase chain reaction. Results Of the 144 cases of lung adenocarcinoma, 62 cases (43.1%) have EGFR gene mutation, whereas 9 cases (6.25%) have KRAS gene mutation.EGFR mutation is shown to be associated with gender (P=0.018) and tumor volume (P=0.016).EGFR mutation is significantly higher in the MPP-positive group than in the MPP-negative group (P < 0.001), whereas KRAS mutation is lower in MPP-positive group than in MPP-negative group (P=0.016).No significant difference in the frequency of EGFR mutation among the three MPP-positive subgroups was indicated (P=0.932). Conclusion The frequency of EGFR mutation in MPPAC is higher compared with that in the other subtypes of lung adenocarcinoma.The frequency of KRAS mutation in MPPAC is lower compared with that in the other subtypes of lung adenocarcinoma.These results indicate its unique molecular biological characteristic. -
表 1 EGFR突变与144例肺腺癌临床病理参数的相关性
例（%） Table 1. Relationship of EGFR mutation with the clinicopathological parameters of 144 cases of lung adenocarcinoma
n(%) 
表 2 MPP阳性组和MPP阴性组临床病理特征
例 Table 2. Clinicopathological features of MPP-positive group and MPPnegative group
n(%) 
表 3 EGFR突变与MPP阳性组临床病理参数的相关性
例（%） Table 3. Relationship of EGFR mutation with clinicopathological parameters in MPP-positive group
n(%) 
表 4 MPP（+, ++, +++）三组间临床病理特征
例（%） Table 4. Relationship of EGFR mutation with clinicopathological parameters in MPP-positive group
n(%) 
表 5 MPP（+, ++, +++）三组的EGFR基因突变状况
例 Table 5. EGFR mutation status of MPP(+, ++, +++)subgroups
n(%) 
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