支气管灌洗液MMP-7基因检测在肺癌诊断中的价值

The diagnosis value of matrix metalloproteinase-7 messenger RNA in bronchial lavage fluid for diagnosis of lung cancer

目的探讨支气管灌洗液基质金属蛋白酶-7(MMP-7)mRNA检测在肺癌诊断方面的价值。方法应用逆转录-聚合酶链反应(RT-PCR)技术,对124例肺癌、103例支气管肺部良性病变患者支气管灌洗液(BLF),进行MMP-7 mRNA表达检测,并与相应的组织病理学检查等结果相比较。结果肺癌、气道良性病变BLF中MMP-7 mRNA表达阳性率分别为24.2%(30/124)、18.4%(19/103),前者高于后者但差异无统计学意义(χ2=1.098,P=0.295)。肺癌患者BLF的MMP-7 mRNA表达强度与患者有无吸烟史均有明显相关性(t=2.666,P=0.011),与性别、年龄,与肿瘤的部位、病理类型、分化程度、肿瘤大小、淋巴结转移、远处转移及临床分期之间均无明显相关性(P值大于0.05)。124例肺癌中其中113例有明确的病理诊断,这113例肺癌患者BLF的MMP-7 mRNA联合细胞病理学阳性率为83.3%(48/113),高于单纯细胞病理学阳性率23.9%(27/113)或MMP-7 mRNA阳性率22.1%(25/113),差异均有统计学意义(χ2=8.801、10.704,P=0.003、0.001)。结论 BLF的MMP-7 mRNA检测对肺癌诊断有一定帮助。

[ Objective ] To explore the diagnosis value of matrix metalloproteinase - 7 （ MMP - 7 ） messenger RNA （mRNA） in bronchial lavage fluid（BLF） for diagnosis of lung cancer. [ Methods] BLF were form 124 cases suffering from lung cancer, and form 103 cases suffering from airway or pulmonary benign diseases respectively. The expression of mRNA of MMP -7 in specimens were detected with the method of reverse polymerase chain reaction （ RT - PCR） , and comparied with the cytopathological examinations. [Results] The positive rate of MMP-7 mRNA in BLF of lung cancer 24.2% （30/124） was not sharply higher than that 18.4% （19/103） of pulmonary benign diseases （X^2 = 1. 098, P =0.295）. There were correlation between MMP-7 mRNA expression in BLF and smoking history（ all P 〈0. 05 ） , while there were no relationships between MMP -7 mRNA expression and sex, age of patients, and site, his- topathological subtype, differentiation, size, lymph node metastases, distant metastasis and clinical stages of lung cancer（ all P 〉 0.05 ）. By detecting MMP - 7 mRNA, the sensibility and specificity of the diagnosis for lung cancer in BLF were respectively ： 24.2% and 81.66%. The sensitivity（ 83.3% ） of MMP - 7 mRNA combined with cytopatholog- ical examination was higher than that of either cytological examination （23.9%） or MMP -7 mRNA （22.1% ） alone （ X^2 = 8. 801, 10. 704 ; P = 0. 003, 0. 001 ）. [ Conclusion] MMP - 7 mRNA in BLF might be helper for diagnosis of lung cancer.