Patholouical Results Of CT Guided Lung Biopsny Speimens And Surgical Specimens And Differences In Detection Of EGFR And ENIL4-ALK Fusion Genes And Its Clinical Significance

Part one Analysis of pathological results between CT-guided lung biopsy specimens and surgical specimensObjective:To investigate the consistency of pathological results between CT-guided lung biopsy specimens and surgical specimens.Method:The diagnostic consistency of CT guided percutaneous lung puncture biopsy,cell smears and surgical specimens on 446 patients with lung occupancy analyzed by statistical analysis.Result:1)Compared with the pathological results of CT guided lung puncture biopsy,the accuracy rate of benign lesions was 81.8%,and that of malignant lesions was 95.6%(Kappa=0.475);Obviously higher than the cytological smear benign lesion accuracy rate(72.7%)and malignant lesion accuracy rate(80.0%)(Kappa=0.309);2)The pathologic results of CT-guided lung puncture biopsy compared with surgical pathologic results showed that the pathologic types were squamous carcinoma,adenocarcinoma and large cell carcinoma,which were 86.0%,96.3%and 77.3%(Kappa=0.807).Conclusion:For lung cancer patients,CT guided percutaneous lung biopsy can be more accurate pathological diagnosis.Part two Comparison of EGFR mutation and EML4-ALK fusion gene between small CT guided lung biopsy specimens and surgical specimensObjective:To investigate the difference of EGFR gene and EML4-ALK fusion gene mutation detection between CT guided lung puncture small sample and surgical pathological specimen.Method:The EGFR gene and EML4-ALK fusion gene were detected by means of real-time PCR and immuno-histochemistry in 831 patients with surgical resection and 242 patients with CT-guided lung puncture biopsy.The results of CT guided percutaneous lung biopsy were compared with that of surgery.ResuIt:1)In surgical resection specimens and CT-guided lung puncture biopsy specimens,the EGFR gene mutations were mainly 19Del and L858R(P<0.01),EGFR gene mutations are more common in women,non-smoking groups,and adenocarcinoma,there are significant statistical differences(P<0.01);In addition,the mutation rate of EGFR in surgical specimens was basically the same as that in lung puncture specimens,and there was no significant statistical difference(P=0.768).2)The positive rate of EML4-ALK fusion gene in lung puncture specimens was significantly lower than that of surgical specimens(P=0.018).Conclusion:The small specimen of percutaneous lung biopsy guided by CT can be used to detect EGFR gene mutation.