Adekvatnost bioptičkih uzoraka za molekularno testiranje receptora za epidermalni faktor rasta (EGFR) u adenokarcinomu pluća
Sažetak
Uvod/Cilj. Adenokarcinom pluća je najčešći histološki tip karcinoma pluća. Najpouzdaniji metod za detekciju mutacija receptora epidermalnog faktora rasta (EGFR) je real time reakcija lančane polimerizacije (PCR). Preporuka je da se biopsijom uzme tri do pet fragmenata tkiva sa minimalno 200–400 očuvanih tumorskih ćelija. Analizirana je adekvatnost bioptičkih uzoraka tkiva za molekularno testiranje EGFR u adenokarcinomu pluća. Metode. Ovom retrospektivnom analizom obuhvaćeno je 60 bolesnika sa dijagnostikovanim adenokarcinomom pluća na Institutu za plućne bolesti Vojvodine u Sremskoj Kamenici, Srbija, u periodu 2010-2015. godina. Bioptički uzorci su dobijeni transbronhijalnom, bronhoskopskom ili kateter biopsijom. Kod svih uzoraka izvršene su morfometrijske analize, određena je koncentracija DNK i prisustvo EGFR mutacije. Udeo tumorskog tkiva u bioptičkom materijalu određen je primenom kompjuterskog programa za morfometrijske analize. Rezultati. Bioptički uzorci su najčešće dobijeni transbronhijalnom biopsijom (63%). U 35% uzoraka nalazio se jedan ili 2 bioptička uzorka. U 68% slučajeva, u uzorcima je nađeno više od 10% tumorskih ćelija, dok je najviše uzoraka imalo između 200 i 500 tumorskih ćelija, a samo 8% uzoraka između 20 i 50 ćelija. U proseku je izolovano 5.81 ng/µL DNK, a značajno niža koncentracija je utvrđena u uzorcima dobijenim kateter biopsijom. U samo dva uzorka evidentirana je mutacija EGFR, dok nije bilo razlike u koncentraciji DNK izolovane iz wild tip I EGFR-mutiranih karcinoma. Bilo je 10% uzoraka neadekvatnih za testiranje. Zaključak. Bioptički uzorci tkiva su adekvatni za molekularno testiranje EGFR u adenokarcinomu pluća.
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