肺癌患者支气管肺泡灌洗液中K-ras基因第1外显子点突变与吸烟的关系

[目的 ]探讨支气管肺泡灌洗液 (BALF)细胞中K ras原癌基因点突变与吸烟的关系及其在肺癌早期诊断中的意义。 [方法 ]应用聚合酶链反应结合限制性片段长度多态性分析法 (PCR RFLP) ,检测了 3 7例吸烟肺癌患者、2 5例非吸烟肺癌患者以及 2 0例肺良性疾病支气管肺泡灌洗液细胞中K ras基因第 12位密码子突变的情况。 [结果 ]肺癌患者K ras基因突变率为 3 5 5 % (2 2 / 62 ) ,肺良性疾病中未发现有K ras基因突变者。突变的发生与患者的年龄及吸烟史有关 ,与性别、TNM分期无关 ;另外 ,重度吸烟者突变率 (68 8% )高于轻度 (2 5 0 % )及中度吸烟者 (3 0 8% ) ,(P <0 0 5 ) ,更明显地高于非吸烟者 (2 0 0 % ) ,(P <0 0 1)。 [结论 ]①吸烟可能是导致K ras基因突变的重要因素之一 ;②BALF细胞中K ras基因突变的检测对肺癌有一定的早期诊断价值 ,可以协助纤维支气管镜提高对周围型肺癌的诊断率

Association between Mutation in Extron 1 of K-ras Gene and Smoking in Bronchoalveolar Lavage Fluid from Patients with Lung Cancer

The mutation of K ras oncogene in bronchoalveolar lavage fluid(BALF) cells was detected in order to find the relationship between smoking and mutation,and its value for early diagnosis of lung cancer. 37 samples of BALF from smoking and 25 from non smoking patients with lung cancer,as well as 20 samples from benign pulmonary diseases were detected for K ras codon 12 mutations by using polymerase chain reaction plus restriction fragment length polymorphism (PCR RFLP). K ras mutation rate in patients with lung cancer was 35 5%(22/62),no mutation was found in patients with benign pulmonary diseases(0/20). Mutation was related to age,history of smoking,but not to sex,stages of TNM classifiation. The mutation rate in heavy smokers(68 8%) was higher than in slight smokers(25 0%) and mid smokers(30 8%)( P <0 05),and was much higher than in non smokers(20 0%)( P <0 01). [Conclusion] (1)Smoking may contribute to the mutation of K ras oncogene. (2)Detection of K ras oncogene mutation in BALF cells might be useful in early diagnosis of lung cancer,which can improve the diagnostic yields of fibro bronchoscopy of peripheral lung cancer.