细针吸取细胞学联合LunX基因定量检测鉴定肺癌淋巴结转移

Diagnosis of Lymph Node Metastasis in Lung Cancer by Fine Needle Aspiration Cytology and LunX mRNA Expression

目的:探讨细针吸取细胞学(fine needle aspiration cytology,FNAC)结合LunX mRNA定量检测在诊断肺癌淋巴结转移中的应用价值。方法:选择46例肺癌患者进行研究,其中鳞癌22例,腺癌17例,小细胞癌4例,低分化癌不能明确类型3例;同期20例非肺癌患者为对照组。利用细针吸取细胞学穿刺取材,结合细胞学和应用逆转录PCR定量检测穿刺样本LunX mRNA表达水平,确定肺癌患者是否存在淋巴结转移。结果:肺癌组穿刺标本中LunXmRNA表达的阳性率为84.8%,对照组穿刺标本的阳性率仅为5%,两组阳性率具有显著性差异(X^2=37.16,P<0.01),并且肺癌转移组与对照组相比较,LunX mRNA平均拷贝数具有显著性差异(Z=-5.807,P<0.01)。肺癌淋巴结转移患者中LunX mRNA表达的阳性率分别为转移性鳞癌86.4%(19/22)、腺癌70.6%(12/17)、小细胞癌75.0%(3/4)、低分化癌66.7%(2/3),各组间无显著性差异(P=0.482),且各组间LunX mRNA平均拷贝数亦无显著性差异(F=0.377,P=0.770)。结论:细针吸取细胞学联合LunX mRNA定量检测判断肺癌淋巴结转移是一种微创、快速、准确的手段,有较高的敏感性和特异性。

Objective： This work investigates the diagnostic significance of fine needle aspiration cytology （ FNAC ） and LunX mRNA for lymph node metastasis in lung cancer. Methods： FNAC was used to examine the lymph nodes of lung cancer patients; quan- titative real-time reverse transcription polymerase chain reaction （ RT - PCR ） was employed to determine the LunX mRNA levels in the biopsy materials. Both these methods could detect whether lymph node metastasis occurred among lung cancer patients. Results： In examining the lymph nodes, LunX mRNA was detected in 84.8% of the patients with lung cancer, whereas only in 5 % patients in the control group （ X^2 = 37.16, P 〈 0.01 ）. LunX mRNA copies in the group with metastatic lung cancer were significantly different with the control group （ Z = - 5.807, P 〈 0.01 ）. Furthermore, the positive rates for LunX mRNA in different histologic types were as follows： 86.3 % （ 19 / 22 ） in metastatic squamous cell carcinoma, 70.6 % （ 12 / 17 ） in adenocarcinoma, 75 % （ 3 / 4 ） in small cell carcinoma, and 66.7 % （ 2 / 3 ） in poorly differentiated carcinoma. No significant difference was observed in the statistical data （ P = 0.482 ） and LunX mRNA copy numbers （ F - 0.377, P = 0.770 ） of these groups. Conclusion： FNAC combined with the detection of LunX mRNA levels is a minimally invasive, rapid, and accurate diagnostic method for diagnosing lymph node metastasis in lung cancer.