标题：胸水细胞蜡块与“新鲜”胸水在肺腺癌EGFR基因检测中的应用

      作者：李晓玲 1，黄仲 2，刘美莲 2    广东医科大学附属医院病理诊断与研究中心 1、肿瘤中心肺部肿瘤病区 2，广东 湛江 524001

      卷次： 2020年31卷20期

      【摘要】 目的 探讨胸水细胞蜡块与“新鲜”胸水在肺腺癌表皮生长因子受体(EGFR)基因突变检测中的应用效果。方法 选取2018年1月至2019年6月在广东医科大学附属医院住院治疗的67例胸腔积液患者，胸水标本常规离心后将沉渣包埋制作成细胞蜡块，经免疫组化明确肺腺癌诊断，检测其EGFR基因的突变(实验组)，将同期送检的一份“新鲜”胸水的EGFR基因检测情况作为对照组。EGFR无任何突变的样本为EGFR阴性，而EGFR有任何突变类型的样本为 EGFR阳性，比较两组标本的阳性率。结果 实验组标本中的 EGFR阳性率为 62.69%(42/67)，明显高于对照组的 44.78% (30/67)，差异有统计学意义(P<0.05)；两组标本同为阳性 27例，同为阴性 22例。结论 与“新鲜”胸水比较，胸水细胞蜡块用于肺腺癌的EGFR基因突变检测更为可靠，能有效指导其分子靶向治疗，值得推广。
      【关键词】 细胞蜡块；新鲜胸水；肺腺癌；基因检测；表皮生长因子受体
      【中图分类号】 R734.2 【文献标识码】 A 【文章编号】 1003—6350（2020）20—,2668—0

3Application of pleural fluid cell wax and "fresh" pleural fluid in EGFR gene detection of lung adenocarcinoma.
LIXiao-ling 1, HUANG Zhong 2, LIU Mei-lian 2. Pathological Diagnosis and Research Center 1, Lung Cancer Ward of CancerCenter 1, the Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, CHINA
【Abstract】 Objective To explore the effect of pleural fluid cell wax and "fresh" pleural fluid on the detectionof EGFR (epithelial growth factor receptor) gene mutation in lung adenocarcinoma. Methods A total of 67 patientswith lung adenocarcinoma, who received in-patient treatment at the Affiliated Hospital of Guangdong Medical Universi-ty from January 2018 to June 2019, were selected. The pleural fluid samples were routinely centrifuged and then the sedi-ment was embedded into cell wax blocks. The diagnosis of lung adenocarcinoma was confirmed by immunohistochemis-try, and EGFR gene mutation was detected as the experimental group. The EGFR gene detection of a "fresh" pleural flu-id was taken as the control group at the same time. Samples with no mutations of EGFR were EGFR negative, and thosewith any mutations of EGFR were EGFR positive. The positive rates of the two groups were compared. Results Thepositive rate of EGFR in experimental group was 62.69% (42/67), which was significantly higher than 44.78% (30/67) inthe control group (P<0.05). Conclusion Compared with "fresh" pleural fluid, pleural fluid cell wax is a more reliableway to detect EGFR gene mutation in lung adenocarcinoma.
      【Key words】 Cell Wax; Fresh pleural fluid; Lung adenocarcinoma; Genetic testing; Epithelial growth factor re-ceptor (EGFR)·短篇论著·doi:10.3969/j.issn.1003-6350.2020.20.023