支气管灌洗液抑癌基因过甲基化对肺癌诊断价值的研究

Study on anti-oncogene hypermethylation in bronchial lavages fluid for the diagnosis of primary lung cancer

目的探讨支气管灌洗液抑癌基因过甲基化对肺癌诊断的应用价值。方法选取北京市结核病胸部肿瘤研究所收治怀疑肺癌患者78例,包括肺癌51例和良性病变患者27例,从支气管灌洗液上清和细胞提取DNA,对上清游离DNA进行定量分析,并采用NMSP完成对支气管灌洗液上清和细胞的过甲基化分析,所选择的靶基因包括p16,MGMT以及RASSF1A基因。将NMSP结果与临床诊断比较,计算敏感性和特异性。结果中心型肺癌、周围型肺癌和肺部良性病变支气管灌洗液上清游离DNA含量没有显著差异。支气管灌洗液细胞抑癌基因过甲基化诊断中心型肺癌的敏感性和特异性分别为85.2%和81.5%,诊断周围型肺癌的敏感性和特异性分别为54.2%和81.5%。支气管灌洗液上清和细胞抑癌基因过甲基化诊断中心型肺癌的敏感性和特异性为88.9%和70.4%,诊断周围型肺癌的敏感性和特异性为75.0%和70.4%。结论支气管灌洗液抑癌基因的过甲基化可为肺癌诊断提供帮助。

Objective To evaluate the value of anti-oncogene hypermethylation in bronchial lav- ages fluid （BLAF） for the diagnosis of primary lung cancer. Methods Seventy-eight patients with lung tumors （containing 51 patients with lung cancer and 27 patients with benign pulmonary le- sions） from Beijing Tuberculosis and Thoracic Tumor Research Institute were selected. DNAs from supernate and cell in bronchial lavages were extracted, quantified, and detected promoter hyperm- ethylation of three target genes, including p16, MGMT and RASSF1A. Using final clinical diagno- sis as control, the sensitivity and specificity of promoter bypermethylation in the diagnosis of lung cancer were analyzed. Results DNA concentrations from supernate of bronchial lavages had not significant difference among central lung cancer, peripheral lung cancer and pulmonary benign le- sions group. The sensitivity and specificity of anti-oncogene hypermethylation from the bronchial lavages cells for the diagnosis of central lung cancer were 85.2% and 81.5% respectively; for peripheral lung cancer were 54.2% and 81.5%, respectively. Combining with the detection of bronchial lavages su- pernates, the sensitivity and specificity for the diagnosis of central lung cancer were 88.9 % and 70. 4 % re- spectively, for peripheral lung cancer were 75.0% and 70. 4% respectively. Conclusions Hypermethyla- tion of anti-oncogene might be an useful marker for the diagnosis of lung cancer.