PCR-TGGE法检测p53基因突变诊断肺癌淋巴结微转移  

Diagnosis of Lymph Node Micrometastases in Human Lung Carcinoma: Determination of p53 Gene Mutations by Polymerase Chain Reaction Temperature Gradient Gel Electrophoresis (PCR-TGGE)

作　　者：徐美林[1] 吴秉铨[2] 钟镐镐[2] 杨霞[1] 衡万杰[2] 

机构地区：[1]天津市胸科医院病理科,天津300051 [2]北京大学医学部病理学系,北京100083

出　　处：《癌症》2004年第7期794-798,共5页Chinese Journal of Cancer

基　　金：天津市卫生局科技基金(No.02KY20)~~

摘　　要：背景与目的转移是影响肺癌患者预后的重要因素之一,但在淋巴结内存在少量癌细胞时常规的检测方法难以发现。本研究的目的是探讨检测肺癌相关淋巴结内微转移存在的敏感方法。方法利用温度梯度凝胶电泳(temperaturegradientgelelectrophoresis,TGGE)方法,对39例原发性肺癌患者的肿瘤组织及其相关的110枚淋巴结,进行p53基因(外显子5,6,7,8)的突变检测,并对部分淋巴结采用无间隔连续切片,证实微转移存在。结果在39例肺癌患者中,23例原发肿瘤检测出p53基因突变,在相应的67枚淋巴结中,40枚淋巴结显示p53基因突变,且与原发灶变化一致;而在常规病理组织学检查时,仅26枚淋巴结存在肿瘤转移。原发肿瘤无p53基因突变者的43枚淋巴结和10枚非瘤患者淋巴结,均无p53基因突变。对常规病理组织学检查阴性,PCR-TGGE检测有p53基因突变的14枚淋巴结,进行无间隔连续切片,在4枚淋巴结中证实有微转移存在。结论p53基因突变的检测发现了肺癌淋巴结中微转移的存在,可以作为常规病理组织学检查的补充。BACKGROUND & OBJECTIVE: Metastasis is one of the most important factors in determining the prognosis of lung cancer patients. However, it is difficult to determine single cancer cell in lymph nodes by routine methods. This study was designed to investigate a sensitive method for detecting lymph node micrometastases in human lung carcinomas. METHODS: Mutation detection for p53 gene (exon 5 8) was performed in 39 cases of primary lung carcinomas and 110 corresponding lymph nodes (LNS) by PCR TGGE method. Serial sectioning was performed to confirm micrometastases in some of these samples. RESULTS: p53 mutations were found in 23 of 39 cases with primary lung cancer. Forty LNSs showed p53 mutation in 67 corresponding LNSs. They were located at the same exon as their primary tumors. Only twenty six LNSs were detected metastases by routine histopathology. Forty three LNSs from sixteen cases of primary tumor without p53 mutation and ten LNSs from the patients without tumor disease did not have any p53 mutations. By PCR TGGE assay p53 gene mutations were determined in fourteen LNSs without histopathological evidence of metastasis. Micrometastases were found in four of the serially sectioned cases. CONCLUSION: Mutation detection for p53 gene (exon 5 8) showed lymph node micrometastases in patients with lung carcinoma. It may be used as a complement for the routine histopathology.

关 键 词：肺肿瘤 淋巴结 微转移 P53基因 

分 类 号：R734.2[医药卫生—肿瘤]