外周血DNA和hTERT在肺癌诊断中的应用  

Application of Serum DNA and hTERT in Diagnose of Lung Cancer

作　　者：王京[1] 吕可洁[1] 朱广昌[1] 

机构地区：[1]首都医科大学附属北京友谊医院胸外科,北京100050

出　　处：《肿瘤防治研究》2008年第9期656-658,共3页Cancer Research on Prevention and Treatment

摘　　要：目的检测肺癌患者血清DNA含量及hTERT的表达水平,寻求微创、高敏感性及特异性的检测方法,为肺癌早期诊断提供新指标。方法41例病理证实肺癌患者,22例正常人设为对照组。磁珠悬浮法提取测定血清DNA含量;巢式PCR法扩增血清hTERT片段,测定灰度比。结果肺癌患者、正常人血清DNA含量均数分别为33.464和18.420,肺癌组血清DNA浓度显著高于正常对照组(P<0.01)。巢式PCR法扩增血清hTERT片段,测定灰度比作为诊断分界点,绘制ROC曲线,AZ=0.852,AZ的95%置信区间为CI(0.750,0.953,P=0.000),因此可以认为血清hTERT对于肺癌的诊断具有中等准确性。诊断分界点=0.4时,其Kappa=0.477,(P<0.01),有统计学意义,其与病理诊断的一致性较好。结论外周血DNA和hTERT在肺癌诊断中具有较好的敏感性和特异性,可能成为肺癌早期诊断的新检测手段。Objective This study designed to assess a quantitative molecular assay of serum DNA and the expression of hTERT in patients with lung cancers to explore a novel noninvasive approach, elevating the sensitivity and specificity in diagnose of lung cancer. We conducted the clinical study to provide a new marker for earlier lung cancer detection. Methods Forty one informed patients with lung cancers and 22 healthy persons were included as control. DNA was extracted from serum samples with MaGaZorb DNA Mini-Prep Kit and quantificated , then hTERT sequences was amplified by nested PCR using gene primers. Reuits Mean concentration of serum DNA between patients with lung cancers and healthy persons was 33. 464 μg/ml and 18. 420 μg/ml respectively. Concentration of free circulation DNA in patients with lung cancers was higher than the other group （P〈0. 01）. The area under the ROC curve by ratio of gray scale was 0. 852 （95% CI, 0. 750 to 0. 953）. Amplification of serum hTERT by nested PCR was a approach with moderate veracity to detect lung cancers. Meanwhile, it had a good coherence with pathology （Kappa = 0. 477,P〈0. 01）. Conclusion The level of free circulating DNA in patients with lung cancers was higher than healthy persons. Amplification of serum hTERT by nested PCR was a approach with high sensitivity. So it may be a new, noninvasive approach for early detection of lung cancers.

关 键 词：肺癌 DNA HTERT 基因诊断 

分 类 号：R392.11[医药卫生—免疫学] R734.2[医药卫生—基础医学]