CDKN2A基因突变对肺癌的影响及与预后的关系

Effects of CDKN2A Gene Mutation on Lung Cancer and Its Relationship with Prognosis

目的探讨多重肿瘤抑制基因(CDKN2A)突变对肺癌的影响及与预后的关系。方法选取肺癌患者63例作为研究对象。比较肺癌患者癌组织及癌旁组织CDKN2A基因突变率;分析肺癌组织CDKN2A基因突变情况与临床病理特征的关系。采用ROC曲线分析CDKN2A基因突变对肺癌的诊断价值;采用生存曲线分析肺癌组织CDKN2A基因突变与预后的关系;采用COX回归分析影响肺癌患者术后生存期的独立危险因素。结果癌组织中CDKN2A基因突变率为38.09%(24/63),癌旁组织中的CDKN2A基因突变率为7.94%(5/63),差异有统计学意义(P<0.05);CDKN2A基因突变型患者复发率为45.83%,高于野生型患者的17.95%(P<0.05)。CDKN2A基因突变诊断肺癌的AUC为0.817(P<0.05),灵敏度为65.08%,特异度为98.41%。CDKN2A基因突变型患者3年生存率低于野生型患者(P<0.05)。CDKN2A基因突变型患者的中位生存时间为34.7个月。Logisitic回归分析显示,淋巴结转移、肺癌分期高、肿瘤大小≥3 cm、CDKN2A基因突变为影响肺癌患者术后生存期的独立危险因素(P<0.05)。结论肺癌患者癌组织CDKN2A基因突变率高于癌旁组织,CDKN2A基因突变对肺癌具有诊断价值,且为影响肺癌患者术后生存期的独立危险因素。

Objective To explore the effects of multiple tumor suppressor gene(CDKN2A)mutation on lung cancer and its relationship with prognosis.Methods 63 patients with lung cancer who were treated were enrolled as the research objects.The mutation rate of CDKN2A gene in cancer tissues and para-carcinoma tissues of lung cancer patients was compared.The relationship between CDKN2A gene mutation in lung cancer tissues and clinicopathological features was analyzed.The diagnostic value of CDKN2A gene mutation in lung cancer was analyzed by ROC curves.Relationship between CDKN2A gene mutation in lung cancer tissues and prognosis was analyzed by survival curves The independent risk factors that affected survival of patients with lung cancer were analyzed by COX regression analysis.Results The mutation rates of CDKN2A gene in cancer tissues and para-carcinoma tissues were 38.09%(24/63)and 7.94%(5/63)(P<0.05).The recurrence rate in patients with CDKN2A gene mutation was higher than with wild-type(45.83%vs 17.95%)(P<0.05).AUC of CDKN2A gene mutation for diagnosis of lung cancer was 0.817(P<0.05),its sensitivity and specificity were 65.08%and 98.41%,respectively.Logisitic regression analysis showed that lymph node metastasis,high lung cancer stage,tumor size not shorter than 3cm and CDKN2A gene mutation were independent risk factors affecting survival of lung cancer patients(P<0.05).The 3-year survival rate in patients with CDKN2A gene mutation was lower than that with wild-type(P<0.05).The median survival time in patients with CDKN2A gene mutation was 34.7 months.Conclusion The mutation rate of CDKN2A gene in cancer tissues is higher than that in para-carcinoma tissues of patients with lung cancer.CDKN2A gene mutation is of diagnostic value for lung cancer,which is an independent risk factor that affects postoperative survival of patients with lung cancer.