肺癌患者肺组织和痰标本p53基因突变检测及其临床意义

目的　探讨肺癌患者支气管肺活检组织和痰标本中p5 3基因突变检测在肺癌诊断中意义。方法　应用聚合酶链反应 (PCR) 单链多肽性 (SSCP) 银染法检测 12 0例肺癌和 40例良性肺疾病支气管肺活检组织和痰标本p5 3基因第 5～ 8外显子突变情况。结果　 60例肺癌患者癌组织、癌旁组织和对侧支气管组织p5 3基因突变检出率分别为 60 % (3 6/ 60 )、17% (10 / 60 )和 5 % (3 / 60 ) ,三组间比较差异有显著性 (P <0 .0 0 5 )。 2 0例良性肺疾病支气管肺组织p5 3基因突变检出率为 5 %。故活检组织p5 3基因突变检出肺癌的敏感性为 60 % ,特异性为 95 % ;另外 60例肺癌痰标本p5 3基因突变检出的敏感性为 43 % (2 6/ 60 ) ,特异性为 10 0 %。肺癌痰标本p5 3基因突变联合细胞学检测使肺癌的诊断率从单纯细胞学的 48% (2 9/ 60 )提高到 68% (41/ 60 )。结论　痰标本p5 3基因检测联合细胞学检查可提高肺癌的诊断率

The clinical significance of detection of p53 gene mutation in patients with lung cancer

OBJECTIVE: To assess the value of detection of p53 gene mutation in bronchial biopsy and sputum samples for the diagnosis of lung cancer. METHODS: Bronchial biopsy and sputum samples were collected from 120 patients confirmed to have lung cancer and 40 patients with benign pulmonary diseases. Polymerase chain reaction-single strand conformation polymorphism-AgNOS(3) staining method (PCR-SSCP) was performed for the detection of point mutation at exon 5 - 8 of the p53 gene. RESULTS: The positive rates of p53 point mutation in the carcinomatous tissue, the para-carcinomatous tissue, the contralateral bronchial tissue and the sputum from patients with lung cancer were 60% (36/60), 17% (10/60), 5% (3/60) and 43% (26/60), respectively (P < 0.05). In patients with benign pulmonary diseases, p53 point mutation in bronchial biopsy sample was detected in only one case (5%). The positive rate for the diagnosis of lung cancer increased from 48% (cytology alone) to 68% when the detection of p53 point mutation and cytological examination for sputum samples were combined. CONCLUSIONS: Detection of p53 gene mutation with PCR-SSCP-silver stain combined with cytological examination of sputum samples can improve the diagnosis of lung cancer.