目的 分析胸腔积液检测EGFR突变阳性的肺腺癌患者的临床特征。 方法 回顾性分析2020年1月至2022年12月蚌埠医学院第一附属医院收治的首次由胸腔积液中检测出EGFR突变阳性的肺腺癌患者的临床特征［包括性别、年龄、吸烟史、有无合并其他基础疾病（如COPD、心血管疾病、糖尿病等）、胸水部位、胸水性质、TNM分期等］，采用SPSS 26.0软件进行统计分析。 结果 共筛选出符合入组条件的患者126例，其中EGFR外显子19缺失突变（19del）患者61例（48.41%），外显子21 L858R突变（21L858R）患者56例（44.44%），非经典突变患者9例（7.14%）。单因素分析显示：3种突变亚型在性别、年龄、吸烟史、有无合并COPD等方面差异均有统计学意义（均P < 0.05），而在胸水部位、胸水性质、肿瘤大小及有无合并心血管疾病、糖尿病、有无远处转移、纵膈淋巴结转移等方面差异均无统计学意义（均P > 0.05）；多因素分析显示：21 L858R突变相对19del突变多好发于男性、年龄大、非吸烟、合并有COPD的患者；非经典突变相对于19del突变患者多好发于男性。 结论 3种突变亚型在性别、年龄、吸烟史、有无合并COPD等方面均有显著性差异；21 L858R突变多好发于男性、年龄大、非吸烟、合并有COPD的患者，而非经典突变多好发男性患者。但仍需要更多病例数研究论证。

Objective To analyze the clinical characteristics of lung adenocarcinoma patients with positive EGFR mutations detected in pleural effusion. Methods We retrospectively analyzed the clinical characteristics including gender， age， smoking history， presence of other underlying diseases （such as COPD， cardiovascular disease， and diabetes）， site of pleural fluid， feature of pleural fluid， and TNM stage in patients with lung adenocarcinoma who had been admitted to the first Affiliated Hospital of Bengbu Medical College from 2020.01 to 2022.12 for the first time by the detection of EGFR mutation positive in pleural effusion. The data were statistically analyzed using the SPSS 26.0 software. Results A total of 126 patients were screened for enrollment， including 61 patients （48.41%） with EGFR exon 19 deletion mutation （19del）， 56 patients （44.44%） with exon 21 L858R mutation （21L858R）， and 9 patients （7.14%） with non?classical mutations. Univariate analysis showed that the three mutation subtypes were statistically significant in terms of gender， age， smoking history， and presence of COPD （P < 0.05 for all comparisons）， but not in terms of pleural fluid site， feature of pleural fluid， tumor size， and presence of cardiovascular disease， diabetes mellitus， presence of distant metastases， and mediastinal lymph node metastases （P > 0.05 for all comparisons）； Multivariate analysis showed that 21 L858R mutation was more likely to be found in male， older age， non?smoking， and presence of COPD than 19del mutation； non?classical mutation was more likely to be found in male than 19del mutation. Conclusions There are significant differences among the three mutation subtypes in sex， age， smoking history， and presence of COPD， but not in pleural fluid location， feature of pleural fluid， tumor size， presence of cardiovascular disease or diabetes mellitus， presence of distant metastases， or mediastinal lymph node metastases； Among lung adenocarcinoma patients with positive EGFR mutations in pleural fluid， 21 L858R mutation mostly occurs in male， older age， non?smokers， and those complicated with COPD， while non?classical mutation mainly develops in male. However， more case studies are needed to confirm the above conclusions.