PTEN和DPC4基因缺失、突变诊断恶性胸腔积液的价值

Values of PTEN and DPC4 deletion or mutation in the diagnosis of malignant pleural effusion

目的:探讨检测胸腔积液中PTEN、DPC4基因缺失、突变诊断恶性胸腔积液的价值。方法:良性胸腔积液组44例、恶性胸腔积液组47例,从胸腔积液中提取DNA,PCR-SSCP法检测PTEN第5～8外显子、DPC4第8～11外显子缺失、突变情况。结果:良性胸腔积液组未发现缺失及突变。恶性胸腔积液组PTEN基因总改变率为46.8%,DPC4基因总改变率为36.2%,联合检测PTEN、DPC4诊断恶性胸腔积液的灵敏度为74.5%,显著高于胸水细胞学检查的53.2%(P<0.05)。结论:PCR-SSCP技术检测胸腔积液中PTEN、DPC4基因缺失、突变可作为鉴别良恶性胸腔积液的辅助指标,具有一定的临床应用价值。

Objective To explore the values of PTEN and DPC4 deletion or mutation in the diagnosis of malignant pleural effusion. Methods 91 patients with pleural effusion were divided into benign pleural effusion group （44 patients） and malignant pleural effusion group （47 patients）. DNA was extracted from pleural effusions. PTEN exons 5 to 8 and DPC4 exons 8 toll were amplified by polymerase chain reaction （PCR） and detected by single-strand conformation polymorphism （SSCP） analysis. Results No deletion or mutation was found in benign pleural effusion group. In malignant pleural effusion group, F＇FEN deletion or mutation was detectable in 46.8% of the patients while DPC4 was in 36.2% of the patients. The sensitivity of combined detection of PTEN and DPC4 was markedly greater than that of cytological examination of pleural effusion （74.5% vs 53.2%, P 〈 0.05）. Conclusions Detection PTEN and DPC4 deletion or mutation in pleural effusion by PCR-SSCP analysis is a useful method in the differential diagnosis of malignant pleural effusion.