肺癌患者痰液脱落细胞端粒酶活性和p53基因突变的检测

Detections of telomerase activity and mutations of p53 gene ln sputa from patients with lung carcinoma and its clinical significance

目的:检测肺癌患者痰液细胞端粒酶活性表达及p5 3基因突变,探讨其作为肺癌早期无创性辅助诊断指标的可能性。方法:采用痰液逆转录-聚合酶链反应-聚丙烯酰胺凝胶电泳(RT-PCR-PAGE)端粒酶活性检测及聚合酶链反应-单链构象多态性分析(PCR-SSCP) ,行p5 3基因突变分析,同时采用巴氏染色法进行脱落细胞检查。结果:6 0例肺癌患者痰液端粒酶活性阳性表达率为5 8.3% ,p5 3基因突变率为4 3.3% ;而2 0例良性支气管-肺病变患者痰液无一例检测到端粒酶活性和p5 3基因突变,差异均有显著性(P <0 .0 0 5 )。6 0例肺癌患者痰液脱落细胞学检查与端粒酶活性阳性表达率和p5 3基因突变率之间差异均有显著性(P <0 .0 0 5～P <0 .0 5 ) ,不同组织学类型及不同部位的肺癌患者痰液端粒酶活性阳性表达率与p5 3基因突变率之间差异均无显著性(P >0 .0 5 )。p5 3基因突变与端粒酶活性阳性表达之间有正相关关系(P <0 .0 1)。结论:痰液端粒酶活性和p5 3基因突变的检测可作为肺癌早期无创伤性检查辅助诊断指标之一,端粒酶活性阳性表达率、p5 3基因突变率与肿瘤部位和组织病理学类型无明显关系,p5

Objective:To investigate the expressions of telomerase activity and mutatioms of p53 gene in sputa from patients with lung carcinomas and to determine whether the detections are of value in the early diagnosis of lung carcinomas.Methods:The expression of telomerase and mutations of p53 gene in sputa RT-PCR-PAGE and PCR-SSCP were employed respectively and the exfolieted cells were examined by standard papanicolaou staining.Results:The expression rate of telomerase activity in sputa from patients with lung was 58.3%and mutations of p53 gene were 43.3%.No telomerase activity and p53 gene mutations were detected in the sputa from patients with benign bronchial-pulmonary diseases.The difference was significant(P<0.05).There were significant differences between the exfolieted cells in sputa from patients with lung carcinomas,the expression of telomerase activity and the mutations of p53 gene(P<0.005-P<0.05).There were no statistical differences (P>0.05) between the mutations of p53 and the expression of telomerase activity with respect to pathological classifications and location of lung carcinomas.There was a positive correlation between the mutations of p53 gene and the expression of telomerase activity(P<0.01).Conclusions:The telomerase activity and the mutations p53 gene in sputa may serve as tumor markers for the early diagnosis of lung carcinomas.The expression rate of telomerase activity and the mutations rate of p53 gene are no statistically irrelevant with the location and pathological classifications of lung carcinomas.p53 gene may regulate the expression of telomerase activity.