肺癌患者术前纤维支气管镜取材检测p53蛋白的诊断价值

Diagnostic value of p53 protein examination in lung cancer through preoperative fibro optic bronchoscope brushing and biospy

目的研究支气管粘膜在肺癌和肺良性疾病情况下纤维支气管镜刷检涂片细胞学标本和活检组织标本中ｐ５３蛋白的表达情况，以探索在肺癌早期诊断中的价值及其与肺门或纵隔淋巴结转移的关系。方法用鼠抗人ｐ５３单克隆抗体，以ｓｐ免疫细胞组织化学方法检测ｐ５３蛋白表达。结果肺癌单纯刷检涂片及单纯活检组织中，ｐ５３蛋白表达阳性率分别为３３．３％（１２／３６）和４７．２％（１７／３６），刷检加活检阳性率为６１．１％（２２／３６）。肺良性疾病刷检涂片及活检组织中，ｐ５３蛋白表达均为阴性，与肺癌比较，差异有显著性（Ｐ＜０．０００１）。结论术前纤维支气管镜取材检测ｐ５３蛋白可作为临床早期诊断肺癌的一个指标，ｐ５３蛋白表达与肺癌组织类型。

Objective To study the expression of p53 protein in lung cancer and benign pulmonary diseases through preoperative fibro optic bronchoscope brushing and biospy as an approach to early diagnosis of lung cancer and to explore correlation between the expression of the gene product and metastatic involvement of hilar or mediastial lymph nodes. Methods Using a monoclonal antibody against p53, the expression of p53 protein was determined by immunocyto histochemical techniques. Results Positive staining of p53 protein of cells obtained form bronchoscopic brushing and biospy was 33.3%(12/36) and 47.2%(17/36) respectively in lung cancer patients. There was 61.1%(22/36) positive staining of cells harvested by brushing plus biospy in lung cancer. No correlation between p53 protein expression and cell differentiation, histologic type or pTNM staging. No p53 expression was observed in benign pulmonary diseases. Conclusion p53 protein expression in cells collected from bronchoscopic brushing and biopsy may be useful in the diagnosis of lung cancer.