胸腔积液中肺腺癌细胞EGFR突变状态与DNA含量的相关性

摘要 目的：探究胸腔积液中肺腺癌细胞表皮生长因子受体（epidermalgrowthfactorreceptor，EGFR）突变状态与DNA含量的相关性，以期探究EGFR突变状态是否同肿瘤的恶性程度存在一定关联。方法：选择2015年1月至2020年1月于我院接受EGFR基因检测以及基因定量分析的591例肺腺癌患者为研究对象，按照其是否出现EGFR基因突变将其分为突变组（335例）与非突变组（256例），两组患者的胸腔积液均使用激光图像细胞仪开展DNA含量以及非整倍体峰检测，并开展组间差异性比较。结果：（1）将591例患者按照年龄、性别及是否吸烟等临床特征进行分组对比显示，性别（P=0.034）与吸烟（P=0.007）同肺腺癌患者胸腔积液细胞出现EGFR突变具有一定关联，而年龄因素与是否出现突变无明显相关性（P>0.05）；（2）突变组患者的最大DNA指数（DI）、大于5C细胞的平均DI以及大于9C细胞的平均DI均明显高于非突变组，组间差异明显（P<0.05）；（3）开展DNA非整倍体细胞峰比较显示突变组在单峰、双峰占比中明显高于非突变组，而无峰占比明显低于非突变组（P<0.05），多峰占比方面两组差异不大（P>0.05）。结论：经研究显示，同未出现EGFR突变的肺腺癌患者相比较，发生EGFR突变的肺腺癌患者明显DI值更高，非整倍体细胞以及非整倍体峰值也呈现异常升高态，这提示EGFR发生突变的肺腺癌患者恶变洗吧的侵袭性更强。

Correlation between EGFR Mutation Status and DNA Content of Lung Adenocarcinoma Cells in Pleural Effusion

ABSTRACT Objective: To explore the correlation between the mutation status of epidermal growth factor receptor (EGFR) and DNA content in lung adenocarcinoma cells in pleural effusion, in order to explore whether the EGFR mutation status is related to the malignant degree of tumor. Methods: A total of 591 patients with lung adenocarcinoma, who underwent EGFR gene testing and genetic quantitative analysis in First Affiliated Hospital of Xi''an Medical College from January 2015 to January 2020 were chosen as research subjects, and they were divided into EGFR gene mutation group(n=335) and non-mutation group(n=256). The pleural effusions of the two groups were detected by laser image cytometry for DNA content and aneuploidy peaks, and the differences between the groups were compared. Results: (1) The 591 patients were grouped and compared according to their clinical characteristics such as age, gender, and smoking status. Gender (P=0.034) and smoking (P=0.007) were certainly related to the EGFR mutation in the pleural effusion cells of patients with lung adenocarcinoma, but age factor was not significantly related to whether there is a mutation(P>0.05). (2) The maximum DNA index (DI), the average DI of greater than 5C cells, and the average DI of greater than 9C cells of the patients in the mutation group were significantly higher than those in the non-mutation group, the difference between the groups was significant (P<0.05). (3) The comparison of DNA aneuploidy cell peaks showed that the proportion of single-peak and double-peak in the mutant group was significantly higher than that in the non- mutation group, but the ratio of no peak was significantly lower than that in the non-mutation group (P<0.05), and there was little difference in the proportion of multi-peaks between the two groups(P>0.05). Conclusion: Studies have shown that compared with lung adenocarcinoma patients without EGFR mutations, lung adenocarcinoma patients with EGFR mutations have significantly higher DI values, and aneuploidy cells and peak aneuploidies are also abnormally elevated. This suggests that patients with lung adenocarcinoma with EGFR mutations are more aggressive.