痰和胸腔积液survivin基因的检测在肺癌诊断中的价值  

Expression of survivin mRNA of sputum and pleural effusions in human lung cancer

作　　者：董德琼[1] 杨渝浩[1] 薛东鹰[2] 冯宪军[3] 

机构地区：[1]遵义医学院附属医院呼吸内科,贵州遵义563003 [2]焦作市人民医院呼吸内科,河南焦作454100 [3]新乡医学院附属医院呼吸内科,河南新乡453000

出　　处：《中南大学学报（医学版）》2006年第6期848-852,共5页Journal of Central South University ：Medical Science

基　　金：贵州省科技厅社会发展基金资助项目(2003036);贵州省科技厅自然科学基金资助项目(20023060)

摘　　要：目的:探讨痰和胸腔积液中survivinmRNA的检测在肺癌诊断中的价值。方法:应用逆转录聚合酶链反应(reversetranscription-polymerasechainraction,RT-PCR)法检测104例肺癌患者痰标本、56例癌性胸腔积液标本、30例慢性阻塞性肺疾病(chronicobstructivepulmonarydisease,COPD)患者和30例结核性胸膜炎胸腔积液标本的survivinmRNA表达,并与细胞学检查结果比较。结果:痰癌细胞的检出率为37.5%(39/104),肺癌患者痰标本survivinmRNA的阳性率为60.6%(63/104);痰survivinmRNA检测联合痰细胞学检查诊断肺癌阳性率为80.8%(84/104),明显高于单独痰细胞学及单独痰survivinmRNA检测的敏感性(均P<0.01)。56例胸水癌细胞的检出率为42.9%(24/56);癌性胸腔积液标本survivinmRNA的阳性率为76.8%(43/56),胸水survivinmRNA检测联合胸水细胞学检查诊断肺癌的敏感性为85.7%(48/56),高于单独胸腔积液细胞学检测的敏感性(P<0.01)。痰及胸水标本survivinmRNA的检测诊断肺癌的特异性分别为90.0%(27/30)和93.3%(28/30),30例COPD患者痰标本及30例结核性胸腔积液标本的survivinmRNA阳性率为10%(3/30)和6.6%(2/30)。结论:痰和胸水中survivinmRNA的检测可作为肺癌早期诊断的一个新的辅助方法,且收集标本简单、易行,重复性好。Objective To determine the diagnostic value of the expression of survivin mRNA in sputum samples and pleural effusions in lung cancer. Methods The sputum samples of 104 patients with lung cancer and 30 patients with chronic obstructive pulmonary disease （ COPD ） , and the pleural effusion of 56 patients with lung cancer and 30 patients with tuberculosis pleural effusions were detected. Reverse transcription-polymerase chain faction（RT-PCR） was performed to detect the survivin mRNA expression in the specimens. The results were compared with their cytological exami- nations. Results The sensitivity of the cytological examinations combined with the detection of survivin mRNA in sputum samples was higher than that of either cytological examination or survivin mRNA detection of sputum samples alone （ P 〈 0.01 ）. The sensitivity of the diagnosis for lung can cer increased from 37.5% （sputum cytology alone） to 78. 8% （sputum survivin mRNA detection combined with sputum cytology ） （P 〈 0. 01 ）, and the negative predictive value increased from 31.6% （ sputum cytology alone） to 43.5 % （ sputum survivin mRNA detection combined with sputum cytology ） （ P 〈 0.01 ）. The sensitivity of the cytological examinations combined with the detection of survivin mRNA in pleural effusion samples was higher than that of cytological examination of pleural effusion samples alone （ P 〈 0.01 ）. The sensitivity of the diagnosis for lung cancer increased from 42.9% （pleural effusion cytology alone ） to 80.4 % （pleural effusion survivin mRNA detection combined with cytology） （P 〈 0.01 ）, and the negative predictive value increased from 48.4% （pleural effusion cytology alone ）to 77.8% （pleural effusion survivin mRAN detection combined with cytology ） （ P 〈 0.01 ）. Conclusion The detection of survivin mRNA from sputum samples and pleural effusions samples is a new diagnostic method for lung cancer.

关 键 词：SURVIVIN MRNA 肺肿瘤 痰 胸腔积液 

分 类 号：R734.2[医药卫生—肿瘤]