One of the most important aspects of interventional pulmonology is to obtain tissue or liquid samples of the chest to diagnose a respiratory disease;however,it is still possible to obtain insufficient tissue or cytolo...One of the most important aspects of interventional pulmonology is to obtain tissue or liquid samples of the chest to diagnose a respiratory disease;however,it is still possible to obtain insufficient tissue or cytologic specimens.Indeed,methylation detection is an effective method by which to establish a diagnosis.This review focuses on the clinical application of short stature homeobox 2 and RAS-associated domain family 1 subtype A DNA methylation detection in interventional pulmonology,including bronchoscopic fluid biopsy,transbronchial needle aspiration,and pleural effusion.展开更多
目的分析检测肺泡灌洗液中大鼠肉瘤(rat sarcoma,Ras)相关区域家族1A基因(Ras association family 1 isoform A,RASSF1A)和矮小同源盒基因2(short stature homeobox 2,SHOX2)甲基化联合径向超声特征对肺结节性质鉴别诊断的意义。方法选...目的分析检测肺泡灌洗液中大鼠肉瘤(rat sarcoma,Ras)相关区域家族1A基因(Ras association family 1 isoform A,RASSF1A)和矮小同源盒基因2(short stature homeobox 2,SHOX2)甲基化联合径向超声特征对肺结节性质鉴别诊断的意义。方法选择2022年9月至2024年3月我院收治的肺结节患者90例,经组织病理学确诊恶性肺结节54例为观察组,良性肺结节36例为对照组,收集肺泡灌洗液进行细胞学检查及RASSF1A、SHOX2基因甲基化检测,比较两组甲基化阳性率,分析肺泡灌洗液甲基化检测对肺结节性质的灵敏度和特异性,采用Logistic回归分析从临床特征、径向超声特征及甲基化指标中筛选预测因子,构建恶性肺结节预测模型。结果观察组RASSF1A阳性22例(40.74%)高于对照组1例(2.78%)(P<0.01)、SHOX2阳性25例(46.30%)高于对照组2例(5.56%)(P<0.01)、RASSF1A及SHOX2两者阳性14例(25.93%)高于对照组1例(2.78%)(P<0.05)、RASSF1A或SHOX2阳性33例(61.11%)高于对照组2例(5.56%)(P<0.01);RASSF1A或SHOX2阳性诊断恶性肺结节的灵敏度61.11%、特异性94.44%。RASSF1A或SHOX2阳性33例(61.11%)高于肺泡灌洗液细胞学阳性17例(31.48%)(P<0.05);RASSF1A或SHOX2阳性联合肺泡灌洗液细胞学阳性率72.22%;观察组径向超声特征中边缘连续比率81.40%、内部回声不均匀比率83.72%及低回声影比率72.09%高于对照组40.00%、40.00%、45.71%(P<0.05);多因素Logistic回归分析显示,两基因甲基化、径向超声特征边缘连续及内部回声不均匀为预测恶性肺结节的危险因素,绘制受试者工作特征曲线下面积(area under the curve,AUC)为0.886。结论RASSF1A联合SHOX2甲基化检测肺泡灌洗液用于恶性肺结节诊断具有价值,RASSF1A及SHOX2甲基化联合径向超声特征对肺结节性质鉴别诊断有临床意义。展开更多
文摘One of the most important aspects of interventional pulmonology is to obtain tissue or liquid samples of the chest to diagnose a respiratory disease;however,it is still possible to obtain insufficient tissue or cytologic specimens.Indeed,methylation detection is an effective method by which to establish a diagnosis.This review focuses on the clinical application of short stature homeobox 2 and RAS-associated domain family 1 subtype A DNA methylation detection in interventional pulmonology,including bronchoscopic fluid biopsy,transbronchial needle aspiration,and pleural effusion.
文摘目的分析检测肺泡灌洗液中大鼠肉瘤(rat sarcoma,Ras)相关区域家族1A基因(Ras association family 1 isoform A,RASSF1A)和矮小同源盒基因2(short stature homeobox 2,SHOX2)甲基化联合径向超声特征对肺结节性质鉴别诊断的意义。方法选择2022年9月至2024年3月我院收治的肺结节患者90例,经组织病理学确诊恶性肺结节54例为观察组,良性肺结节36例为对照组,收集肺泡灌洗液进行细胞学检查及RASSF1A、SHOX2基因甲基化检测,比较两组甲基化阳性率,分析肺泡灌洗液甲基化检测对肺结节性质的灵敏度和特异性,采用Logistic回归分析从临床特征、径向超声特征及甲基化指标中筛选预测因子,构建恶性肺结节预测模型。结果观察组RASSF1A阳性22例(40.74%)高于对照组1例(2.78%)(P<0.01)、SHOX2阳性25例(46.30%)高于对照组2例(5.56%)(P<0.01)、RASSF1A及SHOX2两者阳性14例(25.93%)高于对照组1例(2.78%)(P<0.05)、RASSF1A或SHOX2阳性33例(61.11%)高于对照组2例(5.56%)(P<0.01);RASSF1A或SHOX2阳性诊断恶性肺结节的灵敏度61.11%、特异性94.44%。RASSF1A或SHOX2阳性33例(61.11%)高于肺泡灌洗液细胞学阳性17例(31.48%)(P<0.05);RASSF1A或SHOX2阳性联合肺泡灌洗液细胞学阳性率72.22%;观察组径向超声特征中边缘连续比率81.40%、内部回声不均匀比率83.72%及低回声影比率72.09%高于对照组40.00%、40.00%、45.71%(P<0.05);多因素Logistic回归分析显示,两基因甲基化、径向超声特征边缘连续及内部回声不均匀为预测恶性肺结节的危险因素,绘制受试者工作特征曲线下面积(area under the curve,AUC)为0.886。结论RASSF1A联合SHOX2甲基化检测肺泡灌洗液用于恶性肺结节诊断具有价值,RASSF1A及SHOX2甲基化联合径向超声特征对肺结节性质鉴别诊断有临床意义。
