p16缺失/突变与周围型肺癌CT及病理的相关性研究

Correlative Study of p16 Deletion/Mutation with CT and Pathologic Findings in Pulmonary Squamous Cell Carcinoma and Adenocarcinoma

目的 通过对周围型肺鳞癌和腺癌抑癌基因p16缺失 /突变的检测 ,并将其与鳞癌和腺癌的病理表现、CT表现相联系 ,探讨它们之间的相关性 ,明确具有鉴别诊断价值的CT征象。资料与方法 6 3例肺内肿瘤样病变 ,行普通CT和HRCT检查。利用PCR SSCP法检测病变p16exon2缺失 /突变。结果 鳞癌和腺癌间p16exon2缺失率 /突变率无差异。有淋巴结转移、分化程度低者p16exon2缺失率 /突变率明显增高 (P <0 .0 5 ) ;有短毛刺、棘突、空泡征、胸膜凹陷、灶周短线影的鳞癌和腺癌p16exon2缺失率 /突变率明显高于无以上征象者。结论 鳞癌和腺癌p16缺失 /突变与组织学类型无关 ,p16缺失 /突变可作为评价肺鳞癌和腺癌恶性程度、淋巴结转移潜能及预后的有效指标之一。具有棘突者p16缺失率 /突变率明显增高 ,是周围型肺鳞癌和腺癌最有诊断价值的征象 ,其次为短毛刺、空泡征。

Objective To explore the correlation of p16 exon2 deletion/mutation with CT signs and pathologic findings in pulmonary squamous cell carcinoma and adenocarcinoma, to find out the valuable CT signs in differentiating malignant from benign lesions.Materials and Methods Conventional CT and HRCT were performed in 63 cases with pulmonary mass. The deletion/mutation of p16 exon2 was examined by using PCR-SSCP method.Results No significant difference in p16 exon2 deletion/mutation rate was found between squamous cell carcinoma and adenocarcinoma. In the patients with poorly-differentiated tumor cell and with lymph node metastases, the p16 exon2 deletion/mutation rate was significantly higher (P<0.05). The p16 exon2 deletion/mutation rate was markedly higher in the patients whose tumors carried the signs of short spiculation, spine, vacuole, pleural indentation and short linear shadows.Conclusion Alterations of p16 gene is not correlated to histological pattern of lung tumor. The results indicate that p16 is an important tumor suppression gene, which plays a key role in controlling lung cancer cell proliferation and metastasis. Deletion/mutation of p16 exon2 can be considered as an effective index in evaluating the malignant degree, the potential of metastasis and prognosis for lung squamous cell carcinoma or adenocarcinoma. The spine sign is the most valuable sign in distinguishing malignant from benign tumors.