Abstract
背景与目的表皮生长因子受体(epidermal growth factor receptor, EGFR)突变和KRAS基因突变是非小细胞肺癌(non-small cell lung cancer, NSCLC)靶向治疗的重要分子标志，与临床治疗疗效密切相关。分析肺腺癌EGFR和KRAS基因突变与临床特征的关系。方法收集初治肺腺癌患者395例，有可供检测的肿瘤组织标本。利用突变富集液相芯片法进行EGFR和KRAS基因突变检测。结果395例肺腺癌中，EGFR基因突变192例(48.9%)，KRAS基因突变29例(7.8%)，EGFR和KRAS基因同时发生突变1例(0.3%)。女性和不吸烟患者EGFR基因突变率高于男性和吸烟患者(62.0% vs 37.1%, 61.9% vs 30.3%)，差异具有统计学意义(P＜0.001, P＜0.001)；不同年龄、分期及病理取材标本之间差异均无统计学意义(P＞0.05)。KRAS基因突变在EGFR基因野生型患者中发生率(13.5%, 27/200)明显高于EGFR基因突变患者(1.0%, 2/192)，差异具有统计学意义(P＜0.001)。结论肺腺癌EGFR基因突变在女性和不吸烟患者中较高，KRAS基因突变只在EGFR基因野生型患者中较高。在使用TKI靶向治疗药物之前，应同时检测EGFR基因和KRAS基因的突变情况。
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