In recent years, it has been well known that non-small cell lung cancer (NSCLC) patients with mutations of epidermal growth factor receptor (EGFR) response better to EGFR-tyrosine kinase inhibitor treatment. Although DNA-based assays (e.g. DNA sequencing) are the most frequently used and a relatively reliable method to detect EGFR mutations, they are complex, time-consuming and relatively expensive for routine use in clinical laboratories, besides they require high quality tumor samples. In contrast, the immunohistochemistry (IHC) methods make up fully for the above shortcomings and can serve as screening tests for EGFR mutations. However, there are many factors that can influence the results of IHC methods, such as different staining procedures, different antigen retrieval solutions and different sets of criteria, etc. Thus the IHC methods for detecting EGFR mutations have not been widely used in clinic and only in the research stage. This article reviews the use of IHC methods by different researchers and further discusses how to make the IHC methods work best for the detection of EGFR mutations.
近些年来，人们越来越认识到，存在表皮生长因子受体（epidermal growth factor receptor, EGFR）突变的非小细胞肺癌（non-small cell lung cancer, NSCLC）患者对靶向药物EGFR酪氨酸激酶抑制剂（EGFR-tyrosine kinase inhibitor, EGFR-TKI）的治疗有良好反应。目前，检测EGFR突变应用最多且较为可靠的是以DNA分子为基础的检测（如DNA测序）方法，但此法操作繁琐，耗时长，花费高，对样本要求严格。相比之下，免疫组织化学法（immunohistochemistry, IHC）则充分弥补了上述缺陷，可作为EGFR突变筛查的辅助手段。但影响其结果的因素较多，如不同的免疫组化染色方法、不同抗原修复液的选择及不同的结果评判标准等，因此此法尚未广泛应用于临床，仅处于研究阶段。本文通过检索不同研究者应用免疫组化法对NSCLC患者进行EGFR突变检测的相关文献，进一步讨论如何合理应用免疫组化法检测EGFR突变可发挥其临床应用的最大价值。