肺癌患者肺泡灌洗液中Survivin mRNA表达及其与吸烟相关性的临床研究

Study on expression of surviving mRNA and the correlation between it and smoking in bronchoalveolar lavage fluid in patients with pulmonary carcinoma

目的研究肺癌患者支气管肺泡灌洗液(BALF)中Survivin RNA的表达与吸烟的相关性。方法收集接受纤维支气管镜检查的门诊或住院患者90例,肺癌49例(肺癌组),肺良性病变29例(对照组),正常12例(正常组)。以纤支镜灌洗留取20 mL BALF,采用荧光实时定量RT-PCR法检测Survivin mRNA的表达情况。结果肺癌组Survivin mRNA阳性表达率为92%(45/49),对照组Survivin mRNA阳性表达率为38%(11/29),正常组为17%(2/12),各组间比较均有显著性差异。肺癌组Survivin mRNA虽在鳞癌中表达较高,但与其他类型比较无显著性差异;TNM分期越晚,Survivin mRNA表达越高,有显著性差异。BALF中Survivin mRNA表达与吸烟呈正相关;肺癌组中Survivin mRNA表达与是否吸烟相关,但轻度和重度吸烟组间无显著性差异,非吸烟的良性病变者均为阴性表达。结论 BALF中Survivin mRNA表达在肺癌与肺部良性病变患者中存在显著性差异。吸烟作为一个独立因素影响Survivin mRNA表达。Survivin mRNA表达与是否吸烟有关,但与吸烟程度无相关性。排除吸烟因素的影响,BALF中的Survivin mRNA表达可作为肺癌诊断的一个参考指标,且Survivin mRNA表达量与TNM分期呈正相关,与肺癌组织学类型无相关性。

Objective It is to investigate the expression of surviving mRNA and its correlation with smoking in bronchoalveolar lavage fluid （BALF） of patients with pulmonary carcinoma. Methods 90 cases who were be examined by bronehofiherscope were selected, included 49 cases of lung cancer in lung cancer group, 29 cases of benign lung diseases （BLD） in con- trol group, and 12 cases normal subjects in normal group. The BALF in the examination was collected. The expression of survivin mRNA was measured by fluorescent real-time quantitative RT - PCR in the BALF of all groups. Results The positive expression of surviving mRNA were 92% in lung cancer group, 38% in benign lesions and 17% in normal subjects, there were significant difference among the three groups. In the lung cancer group, although surviving mRNA expression were higher in squamous cell carcinoma, but there was no significant difference compared with other types; TNM stage was later, the surviving mRNA expression was higher, there were significant correlation between them. BALF surviving mRNA expression was positively correlated with smoking, but there was no significant correlation between mild and heavy smoking; surviving mRNA expression correlated. The expression of benign and non-smoking lesions was negative. Conclusion There was significant difference in surviving mRNA expression among three groups. Smoking affected surviving mRNA expression as an independent factor. Surviving mRNA expression is correlated with smoking or not, but no correlation with the degree of smoking, Besides smoking factors, survivin mRNA expression in the BALF can be used as a reference in the diagnosis of lung cancer, and surviving mRNA expression is positively correlated with TNM stage, not related with histological type of lung cancer.