摘要
目的 探讨肺活检和支气管肺泡灌洗液 (BALF)标本 p5 3、K ras和 p16基因检测对肺癌诊断的意义。方法 应用多聚合酶链反应 (PCR)—单链构象多肽性 (SSCP)—银染法和多重PCR分析 ,检测 60例肺癌患者和 18例良性肺疾病患者支气管肺活检组织和BALF标本p5 3基因和k ras基因突变及 p16基因变异 (突变 +缺失 )状况。 结果 肺癌组支气管肺活检标本中 p5 3基因和k ras基因突变、p16基因变异及三基因联合检测阳性率分别是 60 %、3 3 .3 %、41.7%和81.3 % ;相应的BALF标本阳性率为 43 .3 %、3 3 .3 %、3 8.3 %和 73 .3 %。两种标本相应基因异常检出率比较差异无显著性 (P值均 >0 .0 5 )。良性肺疾病组仅活检标本检出 p5 3和K ras基因突变各1例 ,而BALF标本良性疾病组三种基因异常的检出率均为 0。良恶性疾病组比较差异有显著性(P <0 .0 5 )。肺癌组BALF标本不论单基因检测还是联合检测异常率均高于癌细胞的检出率 (P <0 .0 5 )。BALF标本细胞学联合三种基因异常检测可将诊断率从单纯细胞学的 16.6%提高到81.7%。
Objective To investigate the clinical signifi ca nce in diagnosis with measuring the alteration of p53,K ras and p16 genes of t he bronchial biopsy and bronchoalveolar lavage fluid(BALF) specimens in lung can cer.Methods Bronchial biopsy and BALF specimens from 60 cases of lu ng cancer and 18 cases of benign pulmonary diseases were detected for p53 and K ras point mutation as well as p16 abnormality(mutation and deletion) with PCR SSCP AgNO3 staining and multiple PCR.Results Positive rates of p53 and K ras point mutation,p16 ab normality and either of these genes in TBB or TBLB tissue in lung cancer group w ere 60%?33.3%?41.7%和81.3%, respectively.and those in BALF of corresponding p atients were 43.3%?33.3%?38.3%和73.3%, respectively.There was not any signifi cant difference in those gene abnormality rates between TBB or TBLB and BALF spe cimens( P >0.05).For benign pulmonary diseases,in only two cases p53 or K ra s point mutation was detected.Statistic analysis showed there was significant di fference in those gene abnormality between lung cancer group and benign group( P <0.05).For BALF from lung cancer group,abnormality rate of above genes was 8 1.7% higher than that of cytological examination(16.6%).Conclusions The measuring abnormality of p53,K ras and p16 ge ne of BALF might help to make diagnosis of lung cancer.
出处
《临床内科杂志》
CAS
北大核心
2003年第5期237-239,共3页
Journal of Clinical Internal Medicine
基金
安徽省自然科学基金资助项目 (9741 4 0 0 1 )