【摘要】 目的:探讨肺癌中医证型与表皮生长因子(EGFR)基因18,19,20及21外显子突变的相关性。方法:通过四诊合参对患者辨证分型,并检测患者EGFR 18,19,20,21外显子突变情况,进行统计分析。结果:273例患者中气阴两虚108例、阴虚内热58例、脾虚痰湿77例及气血瘀滞30例。吸烟及腺癌患者以气阴两虚、阴虚内热为主,不吸烟及鳞癌患者以脾虚痰湿型为主;早期患者以脾虚痰湿及气血瘀滞型为主,晚期患者以气阴两虚为主。所有患者EGFR 18,19及21外显子无突变。77例患者EGFR 20外显子突变:气阴两虚型27例,阴虚内热型11例,脾虚痰湿20例,气血瘀滞型19例。气血瘀滞型患者突变率为63.33%,明显高于其它证型(P<0.01)。结论:肺癌气血瘀滞型患者EGFR 20外显子突变率较高,此型可能为EGFR酪氨酸酶抑制剂耐药人群。更多还原

【Abstract】 Objective: To investigate the correlation of TCM syndrome of lung cancer and epidermal growth factor receptor(EGFR) gene mutation of exon 18, 19, 20 and 21. Methods: The patients were divided into dif erent TCM syndrome types by synthesis of the four diagnostic methods. The mutation states of EGFR exon 18, 19, 20 and 21 were detected. Statistical analysis was used to analyze the correlation. Results: The patients with deficiency of qi and yin, yin deficiency and internal heat, spleen insui ciency and phlegm-dampness, and qi and blood stasis were 108, 58, 77 and 30 cases, respectively. Dei ciency of qi and yin, yin deficiency with interior heat were two main syndromes in patients with smoking or adenocarcinoma, spleen insui ciency and phlegm-dampness was major syndrome in patients with non-smoking and squamous cell carcinoma. Spleen insui ciency and phlegm-dampness, qi and blood stasis were main syndromes in patients with early stage, and deficiency of both qi and yin was major syndrome in patients with advanced stage. There was no mutation of EGFR exon 18, 19 and 21 in all patients. The mutation of EGFR exon 20 was detected in 77 patients, included 27 patients with deficiency of qi and yin, 11 patients with yin deficiency and interior heat, 20 patients with spleen insui ciency and phlegm-dampness and 19 patients with qi and blood stasis. The mutation rate was 63.33% in patients with qi and blood stasis syndrome, and higher than other syndromes(P<0.01). Conclusion: The mutation rate of patients with qi and blood stasis is higher than other syndromes. This kind of patients maybe EGFR-TKI resistance population.更多还原