韦丽丽++于忠和

[摘要] 目的 探讨肺癌患者转移灶中棘皮动物微管相关蛋白样4-间变性淋巴瘤激酶（EML4-ALK）的阳性表达率及其与临床病理特征、血清指标的关系和使用靶向治疗后的效果。 方法 使用实时荧光定量PCR法（FQ-PCR）对71例肺癌转移灶中EML4-ALK融合基因进行检测，同时检测患者血清标志物癌胚抗原（CEA）、癌糖原（CA125）及血管内皮生长因子（VEGF）水平，分析EML4-ALK融合基因在转移灶中表达情况及与血清标志物水平的相关性。 结果 在淋巴结、脑、骨、体表软组织、肝、结肠和胸膜转移组织中检测到EML4-ALK融合基因阳性表达的组织有淋巴结、脑、骨和胸膜，总阳性表达率为7.04%。转移灶组织中EML4-ALK融合基因表达阳性率与病理类型、性别、年龄、吸烟状态、分化程度和分期因素无明显相关（P > 0.05），但临床上仍以腺癌、不吸烟者人群较多见。血清CEA、CA125、VEGF水平在EML4-ALK融合基因阳性组和阴性组中差异无统计学意义（P > 0.05）。接受克唑替尼治疗的肺癌患者6个月疾病控制率为66%。 结论 使用FQ-PCR技术检测肺癌转移灶中EML4-ALK融合基因是可行的，可以为腺癌、不吸烟这些优势人群提供靶向治疗策略。

[关键词] EML4-ALK融合基因；实时荧光定量PCR反应；肺癌；转移

[中图分类号] R73 [文献标识码] A [文章编号] 1673-7210（2015）05（b）-0004-04

Initially exploring the characteristics of EML4-ALK fusion gene mutation in the metastasis of lung cancer

WEI Lili YU Zhonghe

Department of Oncology， the Military General Hospital of Beijing， Beijing 100700， China

[Abstract] Objective To evaluate the positive expression of the EML4-ALK fusion gene in the metastasis of lung cancer， research the association between EML4-ALK fusion gene and the clinic opathological characteristics as well as the serum markers， and understand the efficacy of targeted therapy. Methods EML4-ALK fusion gene status of 71 cases of patients with metastases tissue lung cancer were detected using FQ-PCR and the serum levels of CEA， CA125 and VEGF were detected. Correlation between EML4-ALK fusion gene expression and serum marker levels were analyzed. Results The metastatic sites with EML4-ALK fusion gene mutation were lymph nodes， brain， bone and pleural tissue， in which the positive expression rate of EML4-ALK fusion gene was 7.04%. Although there was no obvious correlation between the EML4-ALK fusion gene and pathological type， gender， age， smoking status， degree of differentiation and stage （P > 0.05）， most patients were adenocarcinoma or non-smokers. The levels of serum CEA， CA125 and VEGF in EML4-ALK fusion gene-positive patients had no significant difference with those of negative patients（P > 0.05）. The 6 months disease control rate of patient receiving Crizotinib treatment was 66%. Conclusion It is feasible that FQ-PCR technique can be used to detect EML4-ALK fusion gene in metastasis， which may provide targeted treatment strategy for those advantaged generation， such as adenocarcinoma or non-smokers patients.

[Key words] EML4-ALK gene； FQ-PCR； Lung cancer； Metastasis

肺癌是我国乃至全球最常见的恶性肿瘤之一，目前肺癌患者生存期较短，其5年生存率不足15%[1]。肺癌极大地威胁了人类的健康安全。既往对肺癌的治疗主要依赖含铂双药的联合化疗，尽管如此，肺癌的生存期也不尽人意。近年来，随着肺癌分子分型的进展和多个肺癌驱动基因的发现，以及靶向药物的成功应用，肺癌患者的生活质量和生存期大大改善。棘皮……