摘要目的 研究2种表皮生长因子受体(EGFR)突变特异性抗体外显子19中E746-A750缺失和外显子21中L858R点突变的免疫组织化学标记在肺腺癌EGFR突变检测中的应用价值.方法 应用2种抗EGFR突变特异性单克隆抗体E746-A750缺失和L858R点突变对175例石蜡包埋的肺腺癌组织进行免疫组织化学检测,这些病例以往均曾通过直接DNA测序进行过EGFR突变检测.结果 免疫组织化学和直接基因测序2种方法在检测delE746-A750和L858R总体突变率方面并无明显差异[33.7％ (59/175)和30.9％ (54/175),P＞0.05].以基因测序结果为金标准,免疫组织化学检测的敏感性、特异性、阳性预测值和阴性预测值分别为83.1％、95.7％、90.7％和90.9％.结论 EGFR突变特异性抗体E746-A750缺失和L858R点突变的免疫组织化学标记在检测石蜡包埋的肺腺癌EGFR基因突变方面具有较高的敏感性和特异性,是一种经济、快捷和高效的EGFR突变筛选方法.

abstractsObjective To evaluate the immunohistochemical detection of epidermal growth factor receptor(EGFR) mutations using two EGFR mutation-specific monoclonal antibodies:delE746-A750 and L858R.Methods A total of 175 paraffin-embedded lung adenocarcinoma tissue samples previously genotyped by directive DNA sequencing were subject to immunostaining using delE746-A750 and L858R antibodies.Results There was no significant difference of mutation detection between DNA sequence analysis and delE746-A750 and/or L858R immunostaining (33.7％ vs 30.9％,P ＞ 0.05).The overall sensitivity,specificity,positive predictive value and negative predictive value of immunostaining using these two EGFR mutation-specific antibodies were 83.1％,95.7％,90.7％ and 90.9％,respectively.Conclusion With high sensitivity and good specificity,immunohistochemistry using EGFR mutationspecific monoclonal antibodies is an adequate,easy and cost-effective prescreening method to detect EGFR mutations using paraffin-embedded tissue specimens of lung adenocarcinomas.