纤支镜检查联合BALF细胞p53突变的检测对肺癌的诊断价值

目的探讨纤支镜检查联合支气管肺泡灌洗液中细胞p53突变检测对肺癌的诊断价值。方法对可疑肺癌患者行纤支镜检查，并以聚合酶链反应一单链构象多态性（PCR—SSCP）分析法检测BALF细胞p53的第5、6、7、8外显子突变情况。结果在最终确诊的68例肺癌患者中，纤支镜检查诊断肺癌49例，p53突变检测发现37例，纤支镜检查与检测BALF中细胞p53突变联合的方法共同检出61例肺癌患者，阳性率高达89．7％，较单独纤支镜检查差异有高度统计学意义（P〈0．01）。结论PCR—SSCP法检测BALF中p53突变可弥补纤支镜检查的不足，有助提高肺癌的诊断率。

Diagnostic yield of lung cancer with bronchoscopy and detection of p53 mutation in cells from bronchoalveolar lavage fluid

Objective To investigate the value of combination of bronchoseopy and the detection of p53 mutation in cells from bronchoalveolar lavage fluid （BALF） in diagnosing lung cancer. Methods Biopsy, brushing and BALF were taken at fiberoptic bronchoscopy for suspected lung cancer patients, and DNA extracted from BALF cells was analyzed with polymerase chain reaction （PCR）, followed by single-strand conformation polymorphism （SSCP） method, to screen alterations in exon 5, 6, 7 and 8 of the p53 gene. Results All of 68 patients in this study were finally diagnosed as lung cancers. The biopsy and cytological specimens gave a positive result of 49 cases and detection of p53 mutation in BALF cells gave a positive result of 37 cases. Combination of bronchoscopy and p53 mutation detection was more sensitive （85.3%） than bronehoscopy only （P 〈 0.01 ）. Conclusion Detecting gene mutation of p53 in BALF cells might be helpful to make up the bronchoscopy insufficience of biopsy and cytology in diagnosing lung cancer.