基因突变检测技术在非小细胞肺癌表皮生长因子受体与临床病理特征的关系研究中的作用

摘要：目的 探讨非小细胞肺癌（NSCLC）表皮生长因子受体（EGFR）基因突变情况及其与临床病理的关系。方法 选取我院2010年1月至2014年1月收集的159份非小细胞肺癌手术切除标本为研究对象,利用基因测序方法检测标本中的EGFR基因突变情况,并分析其与临床病理的关系。结果 159例样本中,EGFR基因突变检出率为12.6%(20/159),突变主要集中在19号外显子的缺失和21号外显子的点突变。女性患者基因突变检出率明显高于男性患者（P﹤0.01）。腺癌及细支气管肺泡癌患者基因突变检出率明显高于其他组织学分型（P﹤0.01）。高分化患者基因突变检出率高于中－低分化检出率（P＜0.05）。EGFR基因突变与年龄及淋巴结转移与否无关（P＞0.05）。结论 非小细胞肺癌患者EGFR基因突变与性别、组织学分型及分化程度密切相关。     

肺癌的表皮生长因子受体分子靶向治疗与基因突变

肺癌分子靶向治疗近年来取得较大进展,特别是针对表皮生长因子受体（EGFR）分子靶向药物表现出确定的临床效果。临床应用表明,EGFR基因酪氨酸激酶域体细胞突变与非小细胞肺癌患者对酪氨酸激酶抑制剂吉非替尼的敏感性相关,本文就相关的研究进行了简述。     

ARMS法检测非小细胞肺癌表皮生长因子受体基因突变及临床意义

目的：探讨应用突变特异性扩增系统法（ARMS）检测非小细胞肺癌（NSCLC）表皮生长因子受体（EGFR）基因突变的特点。方法：收集220例浙江南部地区NSCLC患者肿瘤样本,分别采用ARMS法和测序法检测EGFR基因18、19、20、21号外显子突变情况,并分析EGFR突变与病理类型、突变种类、患者年龄和性别的关系。结果：两方法比较,相符率为86．81％（158/182,Kappa=0．732,P〈0．01）。总突变率为47．27％（104/220）,其中腺癌的突变率明显高于鳞癌（52．46％zJs17．14％;P〈0．01）。肺腺癌中,女性患者EGFR突变率明显高于男性（65．56％∞39．78％;P〈0．01）。突变样本中,21外显子错义突变（L858R）所占比例最高（62．5％,65/104）,19外显子缺失（19Del）其次（43．27％,45/104）,其中两者同时突变占5．77％（6/104）;但腺癌女性与男性患者L858R突变率（64．41％∞56．76％）不存在显著性差别。结论：采用ARMS法检测EGFR基因突变较测序法敏感,突变主要发生在女性肺腺癌患者,以L858R突变为主。     

肺腺癌组织中表皮生长因子受体基因突变的检测及其临床意义

目的:通过检测肺腺癌组织中表皮生长因子受体(EGFR)基因的突变情况,研究EGFR突变与患者临床特征(性别、年龄和吸烟史)的相关性。方法:收集160例肺腺癌患者术前的石蜡组织标本,提取DNA后用实时定量PCR方法对EGFR基因18~21外显子进行突变检测;对基因突变结果与患者的性别、年龄和吸烟史分别做χ2检验。结果:160例肺腺癌组织标本中,有57例检测到EGFR基因突变,突变率为35.6%,且突变与患者性别、年龄和吸烟史均无显著相关性(P0.05);57例EGFR基因突变标本中,27例为19外显子缺失,22例为21外显子L858R点突变,这2种突变占总突变类型的85.96%,并且与患者性别、年龄及吸烟史无显著相关性(P0.05)。结论:EGFR基因在女性不吸烟肺腺癌中有较高的突变率,突变主要集中在19外显子缺失和21外显子L858R点突变,但突变率及突变类型与患者性别、年龄和吸烟史均不相关。     

基因突变检测技术在非小细胞肺癌EGFR与临床病理特征的关系研究中的作用

目的探讨非小细胞肺癌(NSCLC)表皮生长因子受体(EGFR)基因突变情况及其与临床病理的关系。方法选取我院2010年1月至2014年1月收集的159份非小细胞肺癌手术切除标本为研究对象,利用基因测序方法检测标本中的EGFR基因突变情况,并分析其与临床病理的关系。结果 159例样本中,EGFR基因突变检出率为12.6%(20/159),突变主要集中在19号外显子的缺失和21号外显子的点突变。女性患者基因突变检出率明显高于男性患者(P﹤0.01)。腺癌及细支气管肺泡癌患者基因突变检出率明显高于其他组织学分型(P﹤0.01)。高分化患者基因突变检出率高于中-低分化检出率(P0.05)。EGFR基因突变与年龄及淋巴结转移与否无关(P0.05)。结论非小细胞肺癌患者EGFR基因突变与性别、组织学分型及分化程度密切相关。     

晚期NSCLC患者血液EGFR基因检测研究进展

目的:随着表皮生长因子受体酪氨酸酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI)在非小细胞肺癌(Non-Small Cell Lung Cancer,NSCLC)治疗中的应用,患者的生活质量及生存期均有很大程度的提高,但是,组织表皮生长因子受体(epidermal growth factor receptor,EGFR)检测结果为能否接受EGFR-TKI治疗的先决条件,而晚期肺癌患者却因组织量少、质量不佳、组织异质性无法进行检测,血液EGFR检测便应运而生,本研究将综述晚期非小细胞肺癌(Non-Small Cell Lung Cancer,NSCLC)患者血液EGFR基因检测研究。方法:检索Pub-med、SCI、Medline及中国生物文献数据库中晚期非小细胞肺癌患者血液EGFR基因检测的相关研究。结果:对于晚期NSCLC患者,血液EGFR基因检测有较高的敏感度与特异度,并且能够较好的预测患者对EGFR-TKI的疗效以及进行耐药监测。结论:当组织获取困难及质量不佳时,血液可替代组织行EGFR基因检测。     

表皮生长因子及受体在甲状腺肿瘤中的表达

目的:研究表皮生长因子(Epidermal Growth Factor,EGF)及受体(Epidermal Growth Factor Receptor,EGFR)及在甲状腺肿瘤中的表达。方法:应用免疫组织化学法检测91例甲状腺病变组织中EGFR和EGF的表达情况。结果:结节性甲状腺肿、甲状腺腺瘤、分化型甲状腺癌标本中EGFR表达的阳性率分别为15%、25%、68.62%,EGF表达的阳性率分别为10%、15%、68.62%,其中EGFR、EGF在分化型甲状腺癌与其余两组间差异均有统计学意义(P<0.05)。EGFR和EGF在甲状腺乳头状癌中的表达与性别、年龄、肿瘤大小、淋巴结转移、临床分期等临床因素无明显相关。结论:EGF和EGFR的表达可作为鉴别甲状腺肿瘤良恶性的一个指标。     

陕西省南部地区非小细胞肺癌EGFR基因突变分析

目的:探讨陕西南部非小细胞肺癌表皮生长因子受体基因的突变状况。方法:采用测序方法检测陕西省南部地区233例非小细胞肺癌(non-small cell lung cancer,NSCLCs)患者表皮生长因子受体(epithelial growth factor receptor,EGFR)基因第18、19、20和21号外显子突变情况,并分析其基因突变与肺癌人口学分布及组织类型的关系。结果:233例非小细胞肺癌患者中,共检出82例含有EGFR基因突变,其中第18、19、21号外显子突变率分别为1.3%、16.3%和18.0%,第20号外显子无突变;男性EGFR基因突变率(31.2%,39/125)低于女性(39.8%,43/108);腺癌EGFR基因突变率(39.1%,75/192)高于鳞癌(22%,9/41)。结论:陕西南部NSCLC的EGFR基因突变率较高,以第19、21号外显子突变为主。EGFR基因变率与NSCLC患者性别和病理类型均无关。     

抗人表皮生长因子受体单克隆抗体的制备、鉴定及初步应用

 用人上皮癌细胞系A 431细胞作为抗原免疫BalB/c小鼠,制备七株抗人表皮生长因子受体的单克隆抗体的杂交瘤,这些杂交瘤经三次亚克隆后仍能稳定地分泌单克隆抗体。对其中四株杂交瘤分泌的单克隆抗体进行了鉴定。免疫沉淀放射自显影结果示单克隆抗体3、101和176均可识别A 431细胞膜抗原MW为170000的蛋白质即EGF受体。单克隆抗体59可以识别低分化鼻咽癌细胞膜上EGF受体。单抗3、176和59等可抑制EGF与受体的特异结合,而101和94则不能抑制EGF与受体的结合。 用Protein-A Sepharose CL4B纯化了单抗,纯化的单抗主要为IgG_1亚类。用SDS聚丙烯酰胺凝胶电泳对纯化的单抗进行了纯度测定。     

紫草素逆转埃克替尼对肺癌EGFR-TKI 耐药及其机制的研究

目的:观察紫草素联合埃克替尼对肺腺癌耐药细胞H1975增殖的影响,探讨克服耐药可能的作用机制。方法:应用MTT法检测紫草素(1.25~20μmo/L)、埃克替尼(5~100μmol/L)及两药联合干预对H1975细胞生长的抑制作用;流式细胞术观察紫草素(1.25μmol/L)、埃克替尼(10μmol/L)及联合使用对H1975凋亡作用;Western blot检测不同干预对H1975细胞EGFR、p-EGFR、AKT、p-AKT、ERK、p-ERK和凋亡相关蛋白PARP表达水平的影响。结果:MTT检测结果显示,与单药组相比,联合用药组细胞H1975增殖能力明显减弱,差异有统计学意义(P0.05);流式细胞术结果显示,联合用药组细胞的凋亡率达到(52.45±3.04)%,较紫草素组细胞凋亡率(22±1.17)%和埃克替尼处理组细胞凋亡率(15.35±5.85)%明显提高,差异有统计学意义(P0.05)。Western blot结果显示,单药组下调了p-EGFR、p-Akt蛋白水平的表达,而联合用药组显著抑制了p-ERK、PARP蛋白水平的表达,差异有统计学意义(P0.05),EGFR、AKT、ERK蛋白表达无差异(P0.05)。结论:紫草素联合埃克替尼能明显抑制H1975细胞增殖,促进肿瘤细胞凋亡;抗肿瘤机制可能与调节EGFR信号通路相关蛋白表达有关。     

Stretch-induced fetal type II cell differentiation is mediated via ErbB1-ErbB4 interactions

Stretch-induced differentiation of lung fetal type II epithelial cells is mediated through EGFR (ErbB1) via release of HB-EGF and TGF-α ligands. Employing an EGFR knock-out mice model, we further investigated the role of the ErbB family of receptors in mechanotranduction during lung development. Deletion of EGFR prevented endogenous and mechanical stretch-induced type II cell differentiation via the ERK pathway, which was rescued by overexpression of a constitutively active MEK. Interestingly, the expression of ErbB4, the only ErbB receptor that EGFR co-precipitates in wild-type cells, was decreased in EGFR-deficient type II cells. Similar to EGFR, ErbB4 was activated by stretch and participated in ERK phosphorylation and type II cell differentiation. However, neuregulin (NRG) or stretch-induced ErbB4 activation were blunted in EGFR-deficient cells and not rescued after ErbB4 overexpression, suggesting that induction of ErbB4 phosphorylation is EGFR-dependent. Finally, we addressed how shedding of ligands is regulated by EGFR. In knock-out cells, TGF-α, a ligand for EGFR, was not released by stretch, while HB-EGF, a ligand for EGFR and ErbB4, was shed by stretch although to a lower magnitude than in normal cells. Release of these ligands was inhibited by blocking EGFR and ERK pathway. In conclusion, our studies show that EGFR and ErbB4 regulate stretch-induced type II cell differentiation via ERK pathway. Interactions between these two receptors are important for mechanical signals in lung fetal type II cells. These studies provide novel insights into the cell signaling mechanisms regulating ErbB family receptors in lung cell differentiation.     

Dynamic Analysis of the Epidermal Growth Factor (EGF) Receptor-ErbB2-ErbB3 Protein Network by Luciferase Fragment Complementation Imaging

ErbB3 is a member of the ErbB family of receptor tyrosine kinases. It is unique because it is the only member of the family whose kinase domain is defective. As a result, it is obliged to form heterodimers with other ErbB receptors to signal. In this study, we characterized the interaction of ErbB3 with the EGF receptor and ErbB2 and assessed the effects of Food and Drug Administration-approved therapeutic agents on these interactions. Our findings support the concept that ErbB3 exists in preformed clusters that can be dissociated by NRG-1β and that it interacts with other ErbB receptors in a distinctly hierarchical fashion. Our study also shows that all pairings of the EGF receptor, ErbB2, and ErbB3 form ligand-independent dimers/oligomers. The small-molecule tyrosine kinase inhibitors erlotinib and lapatinib differentially enhance the dimerization of the various ErbB receptor pairings, with the EGFR/ErbB3 heterodimer being particularly sensitive to the effects of erlotinib. The data suggest that the physiological effects of these drugs may involve not only inhibition of tyrosine kinase activity but also a dynamic restructuring of the entire network of receptors.     

The cell surface glycoprotein CUB domain-containing protein 1 (CDCP1) contributes to epidermal growth factor receptor-mediated cell migration

Epidermal growth factor (EGF) activation of the EGF receptor (EGFR) is an important mediator of cell migration, and aberrant signaling via this system promotes a number of malignancies including ovarian cancer. We have identified the cell surface glycoprotein CDCP1 as a key regulator of EGF/EGFR-induced cell migration. We show that signaling via EGF/EGFR induces migration of ovarian cancer Caov3 and OVCA420 cells with concomitant up-regulation of CDCP1 mRNA and protein. Consistent with a role in cell migration CDCP1 relocates from cell-cell junctions to punctate structures on filopodia after activation of EGFR. Significantly, disruption of CDCP1 either by silencing or the use of a function blocking antibody efficiently reduces EGF/EGFR-induced cell migration of Caov3 and OVCA420 cells. We also show that up-regulation of CDCP1 is inhibited by pharmacological agents blocking ERK but not Src signaling, indicating that the RAS/RAF/MEK/ERK pathway is required downstream of EGF/EGFR to induce increased expression of CDCP1. Our immunohistochemical analysis of benign, primary, and metastatic serous epithelial ovarian tumors demonstrates that CDCP1 is expressed during progression of this cancer. These data highlight a novel role for CDCP1 in EGF/EGFR-induced cell migration and indicate that targeting of CDCP1 may be a rational approach to inhibit progression of cancers driven by EGFR signaling including those resistant to anti-EGFR drugs because of activating mutations in the RAS/RAF/MEK/ERK pathway.     

Kinase Activator-Receiver Preference in ErbB Heterodimers Is Determined by Intracellular Regions and Is Not Coupled to Extracellular Asymmetry

The EGF receptor (EGFR) family comprises four homologs in humans collectively known as the ErbB or HER proteins. ErbB proteins are receptor tyrosine kinases that become activated when ligands bind to their extracellular regions and promote formation of specific homo- and heterodimers with enhanced tyrosine kinase activity. An essential feature of ErbB activation is formation of an asymmetric kinase dimer in which the C-terminal lobe of one kinase serves as the activator or donor kinase by binding the N-terminal lobe of a receiver or acceptor kinase and stabilizing its active conformation. ErbB extracellular regions are also thought to form active asymmetric dimers in which only one subunit binds ligand. The observation that the unliganded ErbB2 kinase preferentially serves as the activator kinase when paired with EGFR/ErbB1 implied that extracellular asymmetry in ErbB proteins might be coupled to intracellular asymmetry with unliganded partners favoring the activator kinase position. Using cell-based stimulation assays and chimeric ErbB proteins, we show that extracellular asymmetry is not coupled to intracellular asymmetry and that ErbB intracellular regions are sufficient to determine relative kinase activator-receiver orientation. We further show a hierarchy of activator-receiver preferences among ErbB proteins, with EGFR/ErbB1 being the strongest receiver, followed by ErbB2 and then ErbB4, and that cis-phosphorylation of EGFR and ErbB2 appears to be negligible. This hierarchy shapes the nature of signaling responses to different ligands in cells expressing multiple ErbB proteins.