【摘要】 目的 探讨肺腺癌（LUAD）合并肺结核（PTB）患者的肿瘤驱动基因及程序性死亡受体配体1(PD-L1)表达状态。方法 选取123例LUAD患者，其中合并PTB的47例患者纳入LUAD-PTB共病组，不合并PTB的76例患者纳入单纯LUAD组。所有患者均进行二代测序技术（NGS）基因测序，对组织标本足够的患者同时进行PD-L1免疫组化检测。统计分析两组患者肿瘤驱动基因状态和PD-L1表达情况是否存在差异。结果 患者的NGS检测标本以组织样本为主，占69.9%(86/123)，其他还包括血液、胸腔积液及脑脊液样本。所有纳入的LUAD患者总体表皮生长因子受体（EGFR）突变阳性率为47.2%(58/123)，其中LUAD-PTB共病组患者总体EGFR突变阳性率为31.9%(15/47)，明显低于单纯LUAD组的56.6%(43/76)，差异有统计学意义（P﹤0.01）。两组患者EGFR伴随突变发生率及PD-L1阳性率比较，差异均无统计学意义（P﹥0.05）。结论 LUAD-PTB共病患者的EGFR突变率显著低于单纯LUAD患者，其他基因突变未见显著差异。在PD-L1表达方面，结核感染与肿瘤细胞表面的PD-L1表达无显著关联。更多还原

【Abstract】 Objective To investigate the expression status of tumor driver genes and programmed cell death 1 ligand1(PD-L1) in patients with lung adenocarcinoma(LUAD) complicated with pulmonary tuberculosis(PTB). Method A total of 123 LUAD patients were selected, 47 patients with PTB were included in the LUAD-PTB comorbidity group, and 76 patients without PTB were included in the LUAD alone group. All patients underwent next-generation sequencing(NGS) gene sequencing, and PD-L1 immunohistochemistry was performed in patients with adequate tissue samples. The differences of tumor driver gene status and PD-L1 expression between the two groups were statistically analyzed. Result The majority of NGS samples were tissue samples, accounting for 69.9%(86/123), and other samples included blood,pleural effusion and cerebrospinal fluid. The positive rate of epidermal growth factor receptor(EGFR) mutation in all enrolled LUAD patients was 47.2%(58/123). The positive rate of EGFR mutation in the LUAD-PTB comorbidity group was 31.9%(15/47), which was significantly lower than 56.6%(43/76) in the LUAD alone group, the difference was statistically significant(P<0.01). There were no significant differences in the incidence of EGFR concomitant mutations and PD-L1 positive rate between the two groups(P>0.05). Conclusion The incidence of EGFR mutation in LUAD-PTB patients is significantly lower than that in LUAD patients without PTB, and there is no significant difference in other gene mutations. In terms of PD-L1 expression, there is no significant association between tuberculosis infection and tumor-cell surface PD-L1 expression.更多还原