支气管肺泡灌洗液端粒酶与P53基因检测在肺癌诊断中的应用

The Application Study of Telomerase and P53 Gene in Bronchoalveolar Lavage Fluids in Patients with Lung Cancer

目的研究支气管肺泡灌洗液(BALF)中端粒酶活性、P53基因变异对肺癌的诊断价值。方法收集86例肺癌患者与82例肺良性疾病患者的BALF,采用端粒酶重复序列扩增法(TRAP)和PCR-SSCP法进行端粒酶和P53基因检测,同时经纤维支气管镜(纤支镜)进行活检和刷检。结果①实验组患者BALF端粒酶活性、P53基因突变率分别为82.56%和32.56%,均高于对照组的4.48%和0(P<0.01);②不同组织学类型肺癌患者BALF端粒酶活性阳性表达率和P53基因突变率之间差异均无统计学意义(P>0.05);③中央型肺癌患者BALF端粒酶活性和P53基因变异联合检测阳性率为94.34%,常规纤支镜检查阳性率为86.79%,两者差异无统计学意义(P>0.05)。周围型肺癌患者BALF端粒酶活性和P53基因变异联合检测阳性率75.76%,高于常规纤支镜检查阳性率45.45%(P<0.05)。结论①肺癌患者BALF端粒酶活性与P53基因变异均高于肺良性疾病患者;②端粒酶活性阳性表达率、P53基因突变率与肺癌的病理类型无关;③BALF端粒酶活性和P53基因变异联合检测对周围型肺癌的诊断有一定的实用价值。

Objective To investigate the diagnostic value of telomerase activity and mutatioms of P53 gene in bronchoalveolar lavage fluids （BALF） in lung cancer. Methods Collect BALF from 86 patients with lung cancer and 82 patients with benign bronchial - pulmo- nar diseases. Telomeric Repeat Amplificaton Protocol （TRAP） and Polymerase Chain Reaction Single Strand Conformational Polymorphism（PCR - SSCP） were used in this study. Meanwhile, conduct fibrobronchoscope brush biopsy and protractor biopsy. Results ①The positive rate of telomerase in experimental group is 82.56% and that of mutatioms of P53 gene is 32.56% , which are both higher than 4. 48% and 0% （P 〈 0. 01 ） in control group. ②There were no statistical differences （P 〉 0. 05） between the mutatioms of P53 and the expression of telomerase activity with respect to pathological classification of lung carcinomas. ③ In central - type lung cancer group, the combining positive rate of telomerase and mutatioms of P53 is 94.34% , the positive rate of routine fibrobronchoscope practice is 86.79% , there were no statistical differences between them. In peripheral lung cancer group, the combining positive rate of telomerase and mutatioms of P53 is 75.76% , which is higher than the positive rate of routine fibrobronchoscope practice that is 45.45% （ P 〈 0. 05 ） o Conclusions ①The positive rate of telomerase and that of mutatioms of P53 in lung cancer group＇ s BALF are both higher than that of the group with benign bronchial - pulmonary diseases. ②The positive expression of telomerase in BALF and the rate of mutatioms of P53 are not related to the pathological classification of cancer. ③ The combining detection of telomerase in BALF and mutatioms of P53 has great contributions to the diagnose of peripheral lung cancer.