肺癌切除组织和支气管切缘P^(53)基因突变的研究

The study of P^(53) gene mutations in incisal tissue and bronchial incisal margin of lung cancer

目的 检测肺癌切除组织和支气管切缘P53基因突变 ,了解肺癌手术切除后的效果及局部复发情况。方法 用PCR -SSCP方法将40例肺癌和10例肺部良性肿瘤手术切除标本的支气管切缘 (切缘病理切片无癌细胞残留 ) ,肺癌组织和正常肺组织中的P53基因突变 ,同时对手术后切缘癌复发及转移情况作了随访。结果 12例 (30 % )肺癌支气管切缘和24例肺癌组织存在P53 基因突变 ,至于正常肺组织和良性病变肺组织未发现P53基因突变。本组研究表明 ,肺癌组织P53基因突变以小细胞癌 (98% )最高 ,次为鳞癌 (70% ) ,腺癌(40% ) ,P53基因突变以TNM分期的 ,Ⅲ期 (71.4 % )最高 ,次为Ⅱ期 (58% ) ,Ⅰ期 (26% ) ,术后3～8个月随访 ,支气管切缘P53阳性中5例(41.6% )发生支气管残端复发 ,肺癌组织中P53 阳性有13例 (54% ) ,通过随访发现有癌复发及转移 ;P53 阴性者有3例 (27 % )发现癌复发。两组复发有显著差异 (P<0.05)。结论 本文通过分子检测支气管切缘P53基因突变 ,对早期预测部份肺癌术后残留复发具有重要临床意义。

Objective To study P53 gene mutations in incisal tissue and bronchial incisal margin of lung cancer. Methods P53 gene mutations of lung cancer (40 cases), lung benign tumor and normal pulmonary tissue were detected by PCR-SSCP. Results Among lung cancer patients, 12 cases had P53 gene mutations in bronchial incisal margin and 24 cases had P53 gene mutations in insical tissue. Lung benign tumor and normal pulmonary tissue had no P53 gene mutations. During the follow-up period, 41.6% of those who had P53 gene mutations in bronchial incisal margins and 54% of those who had P53 gene mutations in incisal tissue had recurrence or metastasis of lung cancer, while only 27% of those who had no gene mutations showed recurrence of lung cancer (p<0,05). Conclusion Detecting P53 gene mutations in incisal tissue and bronchial incisal margin of lung cancer was of high value in predicting prognosis of operation.