P21、P53蛋白及热应激蛋白70水平检测对多环芳烃相关肺癌的诊断价值

目的　探讨多环芳烃 (PAHs)相关肺癌的早期诊断指标 ,以期用于职业性肺癌及职业相关肺癌的筛检。方法　采用Western斑点印迹法 ,对确诊的PAHs相关肺癌组 (简称肺癌组 ) 2 9例、非肿瘤性肺病组 2 8例和健康对照组 30例人群的血清中P2 1、P5 3及热应激蛋白 (HSP) 70蛋白水平进行检测。结果　肺癌组患者血清中P2 1、P5 3及HSP70蛋白阳性检出率 (P2 15 8.6 2 %、P5 334.4 8%、HSP704 1.38% )高于非肿瘤性肺病组 (P2 114 .2 9%、P5 37.14 %、HSP70 10 .71% ) ,差异有显著性 (P <0 .0 1) ;血清标本P2 1蛋白敏感性为 5 8.6 2 % ,阴性预测值 (NPV)为 6 8.4 2 % ;P5 3蛋白的敏感性为 34.4 8% ,NPV为 78.0 5 % ;HSP70蛋白的敏感性为 4 1.38% ,NPV为 6 3.0 4 %。 3种蛋白联合检测的敏感性可提高到82 .76 % ,与任何单一指标相比 ,差异均有显著性 (P <0 .0 5 ) ;NPV为 78.2 6 %。 18例细胞学阴性肺癌患者P2 1、P5 3或HSP70阳性 13例 ( 72 .2 2 % )。结论　P2 1、P5 3及HSP70蛋白联合检测对PAHs相关肺癌诊断提供了一套筛选指标 ,同时可补充细胞学的诊断价值

Co-detection of P21 ,P53 and HSP70 and their possible role in diagnosis of polycyclic aromatic hydrocarbons(PAHs)-related lung cancer

Objective To explore the biomarkers of early diagnosis in patients with polycyclic aromatic hydrocarbons(PAHs) related lung cancer for the application to detection of occupational lung cancer or related lung cancer. Methods Western dot blotting was used to explore the expression of ras,p53 and heat stress protein 70(HSP70) in 29 patients with PAHs related lung cancer(LC),and 28 patients with non cancerous pulmanary disease,and 30 healthy controls. Results The positive detection rates of P21,P53,and HSP70 in LC group (58.62%, 34.48%,41.38% respectively) were higher than those in non cancerous pulmonary disease group (14.29%, 7.14%,10.71% respectively, P <0.01).The sensitivity of P21,P53 and HSP70 were 58.62%, 34.48% and 41.38% respectively,negative predictive value(NPV) were 68.42%,78.05% and 63.04% respectively.The co detection of the three proteins mentioned above produced a sensitivity of 82.76% with a NPV of 78.26% ( P <0.05).Of 18 cases of LC with negative cytology,13(72.22%) were found HSP21,P53 or HSP70 positive. Conclusions Co detection of the P21,P53,and HSP70 may be used as the screening marker for diagnosis of PAHs related lung cancer,and may supplement the diagnositic value of conventional cytology.