p16基因第二外显子纯合性缺失检测对肺癌所致胸液的临床价值  

The clinical significance of determination of p16 geneexon2 homozygous deletion in pleural effusion of patients with lung cancer

作　　者：桂淑玉[1] 庞玉英[1] 汪渊[2] 周青[2] 刘虎[2] 

机构地区：[1]安徽医科大学第一附属医院呼吸内科,合肥230022 [2]安徽医科大学分子生物学实验室和安徽省基因研究重点实验室,合肥230032

出　　处：《安徽医科大学学报》2005年第1期26-29,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省自然科学基金 (编号: 01043716);安徽医科大学第一附属医院基金(编号: 99 4)

摘　　要：　目的　探讨p16基因第二外显子纯合性缺失检测对肺癌所致胸腔积液的临床价值。方法　用PCR技术检测 31例肺癌胸液及 21例结核性胸腔积液中p16基因第二外显子纯合性缺失的情况,同时送检胸液脱落细胞学作为对照分析。结果　表明所检 21例结核性胸液无p16基因第二外显子纯合性缺失, 31例肺癌胸液标本中有 12例出现第二外显子纯合性缺失,缺失率为 38 7% ( 12 /31 )。同时 16例脱落细胞学检测阳性,阳性率为 51 62% (16 /31)。在 15例脱落细胞学阴性中,有 6例存在p16基因第二外显子纯合性缺失,两者联合检测阳性率提高至 70 97% (22 /31),明显高于单独检测(P<0 05)。另外,p16基因第二外显子纯合性缺失与肿瘤细胞的组织学类型、转移、预后相关。本组研究表明鳞癌出现p16基因第二外显子缺失的机率虽高于腺癌但差异无显著性;而有淋巴结转移者明显高于无淋巴结转移者(P<0 005)。同时,在 12例p16基因纯合性缺失的患者中有 9例已发生一处以上的肺外转移,预后极差。结论　检测胸液p16基因第二外显子纯合性缺失对肺癌胸腔积液的诊断有重要价值,且特异性高;与脱落细胞学联合检测,可补充和提高其诊断阳性率,对鉴别癌性和结核性胸腔积液及判断肺癌的预后有一定的参考意义。Objective To explore the clinical value of determination of p16 geneexon2 homozygous deletion in pleural effusion of patients with lung cancer. Methods The homozygous deletion of p16 geneexon2 was examined by polymerase chain reaction (PCR) in specimens of malignant pleural effusion from lung cancer,the determination of exfoliated cell in the same specimens,as a control, and compared with tuberculosis pleural effusion. Results No homozygous deletion of p16 geneexon2 was found in 21 tuberculsis pleural effusions while in 12 of 31 malignant pleural effusions homozygous deletion of p16 geneexon2 were observed and exfoliated cells were found in 16 of 31 malignant pleural effusions. The positive rate was 38 71%(12/31) and 51 62%(16/31), respectively. The positive rate of combined both of above methods was 70 97%(22/31), which was much higher than that of only the determination of p16 geneexon 2 homozygous deletion or exfoliated cytology in malignant pleural effusions( P <0 05). On the other hand, p16 geneexon 2 homozygous deletion was correlated with histological type, metastasis and prognosis of tumor cells. Our data showed that the positive rate of p16 geneexon2 homozygous deletion in squamous carcinoma cases was higher than that in adenocarcinoma cases ( P >0 05), in the cases with metastasis it was much higher than in the cases without metastasis( P <0 005). In the 9 of 12 cases with p16 geneexon2 homozygous deletion, extra pulmonary metastasis were found, whose prognosis were very poor but significantly higher than that in the patients without metastasis( P <0 005). Conclusion The determination of p16 geneexon2 homozygous deletion in pleural effusions shows an important referential significance in making a difference between malignant and tuberculous pleural effusions, judging prognosis in patients with lung cancer. Meanwhile, its specificity is high. If combined with exfoliated cytology, the examination of p16 geneexon2 homozygous deletion can supplement and increase the diagnostic value of

关 键 词：肺肿瘤/诊断 胸腔积液 基因 p16 基因缺失 

分 类 号：R561.304[医药卫生—呼吸系统] R734.2[医药卫生—内科学]