肺癌亚临床诊断标准的研究

Research on the standard of sub-clinical diagnosis of lung cancer

目的 探讨痰液 p53基因变异在早期诊断肺癌方面的价值。方法 选择安医大附院呼吸科 1997年 7月至 1997年 10月住院患者 ,其中肺癌 19例 ,男女之比为 16∶ 3,年龄 4 7岁～ 72岁 ,平均年龄 6 1.32岁 ;对照组 (慢性阻塞性肺疾患及肺结核患者 )排除其他系统肿瘤共 2 2例 ,男女之比为 15∶ 7,年龄 4 7岁～ 74岁 ,平均年龄 5 9.4 3岁 ,晨起后清洁口腔 ,连续三天收集痰液于装有固定液 (2 0 ml)的大试管中 ,进行 P53基因 -聚合酶链反应 -单链构象多态性 (P53- PCR- SSCP)分析。结果 肺癌组 9/ 19例痰液中发现 P53基因变异 (P53gene mutations) ,对照组 2 / 2 2例发现 P53基因变异 ,其中一例距临床确诊肺癌提前 3个月 ;对照组与病例组 P53突变率差别有显著性 (X2 =9.0 2 ,P<0 .0 1)肺癌组中 P53基因变异与性别 (P=0 .0 9)、年龄 (P=0 .35 )、吸烟指数 (每日吸烟支数×吸烟年数 ) (P=0 .18)不相关 (以上均为 Fisher确切概率法 )。结论 痰 P53基因检测方法简便、快速 ,经济 ,无创伤性 ,因此 P53基因变异可作为一个有意义的基因标志用于早期诊断肺癌及高危人群筛检。

Objective To explore the value of P 53 gene mutations in sputum in the early diagnosis of lung cancer.Methods The study sample included the inpatients of the department of reparatory diseases of Anhui Medical University Hospital between July 1997 and October 1997.The treatment group consisted of 19 lung cancer patients:the ratio of male to female was 16∶3,the age ranged between 47 and 72 (mean=61.32).The control subjects were 22 cases of COPD and TB patients excluding other tumor complications:the ratio of male to female was 15∶7,the rage ranged between 47 and 74(mean=59.43).All participants were asked to clean their mouths after getting up in the morning.Their sputa were then collected in tubes which had already stored 20ml fixative in each and were sent for P 53 ,PCR and SSCP analyses. Results F or the treatment grpup ,there were 9 out of the 19 cases who had P 53 gene mutation,compared to 2 out of the 22 cases in the control grpup: X 2=9.02,P< 0.01.There were no significant differences between the older and younger patients(P=0.35) and between male andfemale patients(P=0.09) in the detection rate of P 53 gene mutation.Conclusion The detection of P 53 gene mutation is simple and easy to use with no harm on patients.It can be used for screening those who may represent a high risk of lung cancer.