联合检测胸水细胞p53、p16和K-ras基因突变对于肺癌的诊断价值  

Diagnostic value of combination detection of p53,p16 and K-ras mutation of pleural effusion in lung cancer

作　　者：王斌[1] 左孟华[1] 梁爽[2] 

机构地区：[1]吉林大学第一医院呼吸内科,吉林长春130021 [2]吉林大学基础医学院病理生理教研室,吉林长春130021

出　　处：《吉林医学》2007年第17期1833-1835,共3页Jilin Medical Journal

基　　金：2004年长春市科技局资助项目(04-07SF023)

摘　　要：目的:研究胸水细胞p53、p16和K-ras基因突变及三者联合检测对肺癌的诊断价值。方法:研究组为54例伴有恶性胸水的肺癌患者,对照组为28例出现胸水的结核性胸膜炎和其他胸膜炎患者。常规抽取胸水,提取胸水细胞DNA,采用PCR-SSCP方法,分别对p16基因和K-ras基因的第1、2外显子以及对p53基因第7、8外显子进行突变分析。结果:研究组p16基因突变率为33.3%,而对照组只有7.1%,明显低于肺癌患者,差异有统计学意义(P<0.05);研究组K-ras基因突变率(31.5%)也明显高于对照组(3.7%),差异有统计学意义(P<0.05);研究组p53基因突变率为40.7%,而对照组只有7.1%,明显低于肺癌患者,差异有统计学意义(P<0.05)。联合应用p53、p16和K-ras基因突变检测可将胸水细胞中肺癌阳性检出率提高至70.4%。结论:p53、p16和K-ras基因突变对良恶性胸水鉴别诊断具有重要价值,三者联合应用可提高肺癌的诊断率。Objective To study the p53, p16 and K-ras mutation in pleural effusions and the diagnostic value of combination detection of them in lung cancer. Method Fifty - four pleural effusion specimens of lung cancer and 28 pleural effusion specimens of benign lung disease （tuberculous pleurisy and other pleurisy） were involved in this study. DNA were extracted from cells of pleural effusions and PCR - SSCP was employed to analyze the mutation of p16 exon 1 and 2, K - ras exon 1 and 2, and p53 exon 7 and 8. Results 33.3% （18/54） of lung cancer patients showed p16 gene mutation, and only 7.1% in benign disease, which was significantly lower than lung cancer patients （ P 〈 0.05）. There was also a significant difference in the mutation rate of K - ras gene in the two groups （ P 〈 0.05）, the lung cancer patients （ 31.5% ） was higher than benign lung disease （ 3.7% ）. The mutation rate of p53 in lung cancer patients （40.7%） was much higher than that （7.1%） of benign lung disease （P〈0.05）. If the p53, p16 and K -ras gene mutation were combined detected,the positive rate of lung cancer was elevated to 70.4%. Conclusion Mutation of p16, p53 and K - ras gene may be a valuable biomarker to distinct malignant from benign pleural effusions and combination detection of them can elevate the positive rate of lung cancer.

关 键 词：肺癌 胸水 P16基因 K-RAS基因 p53基因 

分 类 号：R734.2[医药卫生—肿瘤]