肺癌患者癌组织和痰液细胞中p53和K-ras基因突变的研究

Study on the mutations of p53 and K-ras gene in the cancer tissues and sputum cells of patients with lung cancer

目的 检测肺癌组织和肺癌患者痰液脱落细胞中p5 3、K ras基因突变情况 ,比较联合检测p5 3、K ras和单一检测p5 3或K ras基因在肺癌诊断中的价值。方法 应用PCR SSCP -银染法检测了 5 9例肺癌组织、癌旁肺组织、14例肺部良性病变肺组织及患者痰液脱落细胞中p5 3基因第 5～ 8外显子、K ras基因第 1外显子突变。结果 肺癌组织中p5 3基因突变率为 37.3 % (2 2 / 5 9) ,痰液脱落细胞为 33 .9% (2 0 / 5 9) ,两组间比较无显著性差异 (P >0 .0 5 )。肺癌组织和患者痰液脱落细胞中K ras基因突变率分别为 2 3 .7% (14 / 5 9)和2 0 .3 % (12 / 5 9)。肺良性病变肺组织和肺良性疾病患者痰液脱落细胞中均未检测到p5 3和K ras基因突变。肺腺癌组织K ras突变率 (44 % ,11/ 2 5 )显著高于其它类型的肺癌 (8.8% ,3/ 34) (P <0 .0 1)。吸烟肺癌患者p5 3突变率 (48.7% ,19/ 39)显著高于非吸烟肺癌患者 (15 % ,3/ 2 0 ) (P <0 .0 1)。联合检测肺癌患者痰液脱落细胞p5 3和K ras基因突变率为 5 4.2 % (32 / 5 9) ,显著高于痰脱落细胞中 33 .9%的p5 3突变和 2 0 .3 %的K ras突变率。结论 联合检测肺癌患者痰液脱落细胞中p5 3和K ras基因突变 。

Objective To investigate the mutations of p53 gene and Kras gene in cancer tissues and sputum cells of patients with lung cancer, and to evaluate their values on detection of lung cancer. Methods The mutation of exon 58 of p53 gene and exon 1 of Kras gene in cancer tissues and sputum cells was detected in 59 patients with lung cancer and in 14 patients with benign pulmonary lesions as control by PCRSSCPAgNO 3 staining method. Results The mutation rate of p53 was 37.3%(22/59) in cancer tissues, and 33.9%(20/59) in sputum cells. No significant difference was observed between the two groups (P>0.05). The mutation rate of Kras gene was 23.7%(14/59) and 20.3% (12/59) in cancer tissues and sputum cells respectively. No mutation of p53 and Kras was detected both in benign pulmonary lesion tissues and sputum cells in patients with benign pulmonary diseases. The mutation rate of Kras in adenocarcinoma (44%, 11/25) was significantly higher than that in other histological classification of the cancer (8.8%, 3/34) (P<0.01). p53 mutation (48.7%) in smokers with lung cancer was significantly higher than that (15%) in nonsmokers with lung cancer (P< 0.01 ). The mutation rate (54.2%) of combination detection of p53 and Kras in sputum cells was significantly higher than that of p53 (33.9%) or Kras (20.3%) alone (P<0.05).Conclusion Combined detection of p53 and Kras mutation in sputum cells of patients with lung cancer may help the diagnosis of lung cancer.