肺癌患者支气管肺泡灌洗液游离RNA测定的临床意义

The clinical significance of detecting cell-free RNA in bronchoalveolar lavage fluid of patient with lung cancer

目的探讨肺癌患者支气管肺泡灌洗液(BALF)和血浆游离磷酸甘油醛脱氢酶(GAPDH)mRNA的表达及其临床意义。方法以确诊的43例肺癌作为实验组,17例肺部良性病变作为对照组,采用实时定量逆转录聚合酶链反应测定BALF上清和血浆中游离GAPDH mRNA的拷贝数。常规细胞学方法检测BALF脱落细胞。应用受试者工作特征(ROC)曲线分析方法评价游离RNA诊断价值。结果(1)肺癌及良性疾病组BALF和血浆中均可检测到游离RNA的存在。(2)肺癌患者BALF中游离RNA拷贝数明显高于肺良性病变组(P<0.01),但血浆中游离RNA两组比较差异无统计学意义。(3)BALF细胞学检查肿瘤细胞阳性组游离RNA拷贝数明显高于阴性组(P<0.05)。(4)肺癌游离RNA拷贝数在不同的病理类型、临床分期中无统计学差异(P>0.05)。(5)ROC曲线分析BALF游离RNA对肺癌的诊断价值:当特异性为100%和90%时,诊断的敏感性分别为65.3%和70.1%,ROC曲线下面积达0.832。结论应用荧光定量PCR方法检测BALF中游离RNA诊断肺癌具有较高的特异性和敏感性。

Objective To investigate the clinical value of cell-free RNA in bronchoalveolar lavage fluid（BALF） supernatant and plasma in patients with lung cancer. Methods The copies of cell-free RNA in plasma and BALF were measured by real time quantitative PCR in 43 patients with lung cancer and 17 patients with benign lung diseases. The cell-free RNA copies in two groups were analyzed by receiver operating characteristic curve （ROC）. Results .（1） Cell-free RNA was dectected in BALF and plasma of two groups. （2）The copies of BALF cell-free RNA in lung cancer group were much higher than those in benign disease group （P〈0. 01）, but the difference of cell free RNA level in plasma was not significant between two groups. （3） It was also found that the copies of RNA in BALF with positive cancer cells were higher than those with the negative cancer cells （P〈0. 05）. （4） The correlation between the clinical pathological data and cell free RNA level was not found. （5） ROC of ceil-free RNA in BALF analysis showed that the sensitivity was 65.3% while the specificity could reach 100%, the area under ROC curve was 0. 832. Conclusion The measurement of cell-free RNA in BALF with RT-PCR has higher sensitivity and specificity in diagnosis of lung cancer.