目的：探讨肺腺癌新分类与表皮生长因子受体(epidermal growth factor receptor，EGFR)基因突变之间的关系。方法：共纳入中日友好医院2010年3月至2014年12月经手术肺切除术后且病理证实为浸润性肺腺癌患者94例，对其进行EGFR基因突变检测；入组患者均按照2011 年国际肺癌研究学会（Intemational Association for the Study of Lung Cancer，IASLC)、美国胸科学会（American Thoracic Society，ATS）和欧洲呼吸学会（European Respiratory Society，ERS）分类方法进行肺腺癌亚型分类，分析肺腺癌新分类与EGFR基因突变之间的关系；采用SPSS 20.0统计软件卡方检验分析，P＜0.05为差异有统计学意义。结果：入组的94例肺腺癌患者，男、女患者均为47例；年龄24～79岁，中位年龄61岁，60岁及以上48例，60岁以下46例；既往或现在吸烟者34例，不吸烟者60例。根据病理分期，Ⅰ期患者34例，Ⅱ期患者17例，Ⅲ期24例，Ⅳ期19例。EGFR基因外显子19突变例数22，外显子20突变例数2，外显子21突变例数26，外显子10和21同时突变例数1，入组患者EGFR基因总突变率为54.3%（51/94），其中腺泡状为主型肺腺癌EGFR突变例数24例，伏壁状为主型肺腺癌14例，乳头状为主型肺腺癌与实体状为主型肺腺癌均为5例，微乳头状为主型肺腺癌3例，黏液腺癌为0；腺泡状为主型肺腺癌较非腺泡状为主型肺腺癌EGFR突变率高，但差异无统计学意义(66.7% vs. 46.6%， P=0.057)；实体状为主型肺腺癌较非实体状为主型肺腺癌EGFR突变率低，差异有统计学意义（26.3% vs. 61.3%， P=0.005）；黏液腺癌较非黏液腺癌EGFR基因突变率低，差异有统计学意义(0 vs. 57.3%， P=0.018)。结论：不同的病理亚型肺腺癌EGFR突变率存在差异，其中腺泡状为主型肺腺癌较非腺泡状为主型肺腺癌的EGFR基因突变发生率高，实性为主型肺腺癌较非实性为主肺腺癌 EGFR突变发生率低，黏液腺癌较非黏液腺癌EGFR基因突变率低。

Objective： To evaluate the association of the histological subtype of lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutation. Methods: A total of 94 patients with resected lung adenocarcinoma in the Department of Thoracic Surgery of China-Japan Friendship Hospital from Ja-nuary 2010 to December 2014 were enrolled in the study. All specimens were tested for EGFR mutation by a company. In the 94 patients, histological subtypes were classified according to the 2011 International Association for the Study of Lung Cancer and American Thoracic Society and European Respiratory Society classification. We compared the association with the histological subtype of lung adenocarcinoma with EGFR mutation frequency by the χ2 test, with SPSS 20.0. Results: The 94 patients of surgically resected lung adenocarcinomas were included in this analysis，of whom，47 were male and 47 female (male ∶female= 1 ∶1) . The median age was 61 (range: 24-79) years, and 48 of the 94 patients were 60 years and above. Regarding the pathological staging, 34 patients were diagnosed as Stage Ⅰ of the disease,17 as Stage Ⅱ,24 as Stage Ⅲ, and 19 as Stage Ⅳ. Among the 51 patients with EGFR mutation, exon 19 mutation was 22, exon 20 mutation was 2, exon 21 mutation was 26, exon 20 and 21 mutation were 1, and the total EGFR mutation rate was 54.3% (51/94). The cases of EGFR gene mutation of acinar predominant lung adenocarcinoma, lepidic predominant lung adenocarcinoma, papillary predominant lung adenocarcinoma, solid predominant lung adenocarcinoma, micropapillary predominant lung adenocarcinoma and mucious adenocarcinoma were 24, 14, 5, 5, 3, and 0, respectively. The rate of EGFR gene mutation of acinar predominant lung adenocarcinoma was higher than that of non-acinar predominant lung adenocarcinom, but there was not statistically significant (66.7% vs. 46.6%， P=0.057). The rate of EGFR gene mutation of solid predominant lung adenocarcinoma was lower than that of non-solid predominant lung adenocarcinom （26.3% vs. 61.3%， P=0.005). The rate of EGFR gene mutation of mucious adenocarcinoma was lower than that of non-mucious adenocarcinom (0 vs. 57.3%， P=0.018).Conclusion: There is heterogeneity of EGFR mutation in lung adenocarcinoma. The presence of lung adenocarcinoma with acinar indicates a higher EGFR mutation rate, while the solid and mucinous component indicates a lower EGFR mutation rate.