国际肿瘤学杂志

国际肿瘤学杂志 ›› 2014, Vol. 41 ›› Issue (8): 615-619.doi: 10.3760/cma.j.issn.1673-422X.2014.08.018

• 论著 • 上一篇    下一篇

晚期非小细胞肺癌肿瘤组织原发灶和淋巴结转移灶c-MET基因扩增的研究

李扬，于忠和   

  1. 100007 北京军区总医院全军肿瘤内科诊治中心（李扬、于忠和）;山西医科大学第二临床医学院（李扬）
  • 收稿日期:2014-01-13 修回日期:2014-02-19 出版日期:2014-08-15 发布日期:2014-08-14
  • 通讯作者: 于忠和，E-mail:zhonghe7788@263.net E-mail:zhonghe7788@263.net
  • 基金资助:

    国家自然科学基金（81372489）

c-MET gene amplification in advanced primary non-small cell lung cancer and associated lymph node metastases

Li Yang, Yu Zhonghe   

  1. Diagnosis and Treatment Center of Oncology, General Hospital of Beijing Military Region, Beijing 100007; Second Clinical Medical College, Shanxi Medical University, Taiyuan 030001, China
  • Received:2014-01-13 Revised:2014-02-19 Online:2014-08-15 Published:2014-08-14
  • Contact: Yu Zhonghe E-mail:zhonghe7788@263.net

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摘要： 目的 研究晚期非小细胞肺癌（NSCLC）原发灶和转移灶c-MET扩增阳性率，探讨其相关性。方法 收集2011年11月至2013年11月北京军区总医院NSCLC原发灶147例，其中配对淋巴结转移灶71例，另取正常肺组织标本47例作为对照，使用反转录聚合酶链式反应检测其c-MET拷贝数，统计得出c-MET扩增阳性率并分析原发灶与淋巴结转移灶c-MET扩增的一致性、c-MET扩增阳性与临床基线资料间的关系。结果 c-MET基因扩增阳性率原发灶为8.84%（13/147）。c-MET扩增阳性率配对原发灶为8.45%（6/71），配对淋巴结转移灶为18.31%（13/71），转移灶扩增阳性而对应的原发灶扩增阴性8例，原发灶扩增阳性而对应的转移灶扩增阴性1例，两组间差异有统计学意义（McNemar检验，χ2=4.274，P=0.039）。用淋巴结转移灶预测原发灶cMET扩增阳性，其一致性良好（Kappa值=0.464，P＜0.001），敏感性为83.3%，特异性为87.7%。c-MET扩增阳性的临床特征为N2以上淋巴结转移的男性、吸烟NSCLC患者。结论 c-MET扩增检测应当作为常规基因检测项目；NSCLC淋巴结转移灶阳性率高于原发灶，检测转移灶能筛出更多有适应证的患者；转移灶可预测原发灶cMET扩增情况，指导临床使用c-MET靶向药物；NSCLC的临床特征是预测c-MET扩增阳性的指标之一。

关键词: 癌, 非小细胞肺, c-MET, 淋巴转移

Abstract: Objective To examine the positive rate of cMET gene amplification in primary and lymph nodemetastatic non-small cell lung cancer (NSCLC), and to explore their relationships. MethodsFrom November 2011 to November 2013, 147 cases of primary NSCLC consisting of 71 cases of paired lymph nodemetastatic tumors and 47 cases of normal lung specimens as the control group were collected in General Hospital of Beijing Military Region. The cMET gene copy number was examined by RTPCR and the positive rate of cMET gene amplification among NSCLC population was figured out, thus the consistency of c-MET gene amplification in advanced primary NSCLC and associated lymph nodemetastases and the relationship between cMET gene amplification and clinical data were analyzed. ResultsThe positive rate of cMET gene amplification on primary tumor was 8.84% (13/147). For those 71 paired cases, the positive rate on primary tumor was 8.45% (6/71), with that of lymph nodemetastases 18.31% (13/71). Among the 71 cases, there were 8 cases whose metastases were positive but primary tumors negative and 1 case whose primary tumor was positive but metastases negative. It was of statistical significance between the two groups (McNemar test, χ2=4.274, P=0.039). The positive rate of primary tumors could be predicted by lymph node metastases (κ=0.464, P＜0.001). The sensitivity was 83.3% and the specificity was 87.7%. Positive rate of c-MET amplification was higher in male and smoking patients with lymph node metastases above N2. ConclusioncMET amplification test should be one of the routine genetic testing projects. The amplification on primary tumors is higher than that on lymph nodemetastases, implying that metastases test can pick out more patients with indication. Metastases test can predict the amplification on primary focus, and it is an alternative way to guide the treatment of c-MET target medicine. Moreover, the clinical characteristic can be served as an indicator of positive c-MET amplification.

Key words: Carcinoma, non-small-cell lung, c-MET, Lymphatic metastasis