支气管冲洗液中表皮生长因子受体检测在支气管快速细胞学评估阴性患者中的检测价值

Detection of Epidermal Growth Factor Receptor in Bronchial Lavage Fluid in Patients with Negative Rapid Cytological Assessment

摘要: 目的：探究支气管冲洗液中表皮生长因子受体检测在支气管快速细胞学评估阴性患者中的检测价值，为肺癌的早期诊断提供新的思路和方法。方法：本研究为回顾性研究，以自2017年1月1日至2019年6月1日入我院呼吸内科的可疑肺肿瘤患者为研究对象，共62例，利用支气管镜下快速细胞学评估，收集支气管灌洗液，利用RT-PCR试剂盒检测支气管灌洗液中表皮生长因子受体(EGFR)基因突变的表达量。结果:共62例患者入组，其中男性26例，女性36例，年龄为42岁~81岁，平均年龄为(57.35 ± 5.98)岁。随访时间为9~32个月。62例患者经支气管镜下快速细胞学评估阴性的患者，后经过肺穿刺，手术切除和转移灶活检明确诊断32例确诊为原发性肺癌(其中肺腺癌22例、肺鳞状细胞癌5例、小细胞肺癌3例、非小细胞肺癌未分型1例、大细胞癌1例)，30例为良性病变(其中肺部结节20例，肺部感染10例)。支气管冲洗液上清液中共检测出30例EGFR突变型，32例EGFR野生型，灵敏度为93.75% (30/32)，特异度为100.0% (62/62)，阳性预测率为100.0% (30/30)。结论：支气管冲洗液中表皮生长因子受体(EGFR)基因检测可以有效弥补支气管镜活检的不足，为临床上肺癌的诊断提供新的思路和方法，值得进一步推广和应用。

Abstract: Objective: To explore the detection value of epidermal growth factor receptor (EGFR) in bronchial lavage fluid in patients with negative rapid cytology assessment, and to provide new ideas and methods for early diagnosis of lung cancer. Methods: 62 patients with suspected lung tumor ad-mitted to the department of respiratory medicine of our hospital from January 1, 2017 to June 1, 2019 were selected as the research objects. Rapid cytological evaluation under bronchoscope was used to collect broncholavage fluid. The expression of epidermal growth factor receptor (EGFR) gene mutation in bronchoalveolar lavage fluid was detected by RT-PCR kit. Results: A total of 62 patients, including 26 males and 36 females, aged from 42 to 81 years, with an average age of (57.35 ± 5.98) years. The follow-up time was 9 - 32 months. Sixty two patients were diagnosed as primary lung cancer (including 22 cases of lung adenocarcinoma, 5 cases of lung squamous cell carcinoma, 3 cases of small cell lung cancer, 1 case of non-small cell lung cancer and 1 case of large cell carcinoma) after lung puncture, surgical resection and metastasis biopsy. There were 20 cases of pulmonary nodules and 10 cases of pulmonary infection. The sensitivity, specificity and positive predictive rate of EGFR were 93.75% (30/32), 100.0% (62/62) and 100.0% (30/30) respectively. Conclusion: The detection of epidermal growth factor receptor (EGFR) gene in bronchial lavage fluid can effectively make up for the deficiency of bronchoscopy biopsy, and provide new ideas and methods for clinical diagnosis of lung cancer, which is worthy of further promotion and application.