机构地区:[1]重庆市涪陵中心医院呼吸科,408000 [2]成都军区总医院干部病房,610083
出 处:《重庆医学》2008年第20期2302-2304,2307,共4页Chongqing medicine
摘 要:目的探讨联合检测p16基因启动子异常甲基化和微卫星不稳定性(MSI)改变在肺癌早期诊断及与肺结核的鉴别诊断中的意义。方法利用甲基化特异PCR法检测肺癌组、肺癌前病变组、正常肺组织组和肺结核组p16基因启动子甲基化情况;采用PCR单链长度分析法检测肺癌组、肺癌前病变组、正常肺组织组和肺结核组细胞的MSI。结果肺癌组启动子甲基化的发生率显著高于癌前病变组(P<0.05)和正常肺组织组(P<0.01);癌前病变组启动子甲基化发生率显著高于正常肺组织组(P<0.05);癌前病变组MSI的发生率显著高于肺癌组(P<0.05)和正常肺组织组(P<0.01);肺癌组MSI的发生率显著高于正常肺组织组(P<0.05),肺结核组织中未检测到p16启动子甲基化和MSI的发生。对p16启动子甲基化和MSI进行相关性分析,结果显示二者之间差异无统计学意义(P>0.05)。联合检测启动子甲基化和MSI的敏感性显著高于单一检测启动子甲基化(P<0.05)和MSI(P<0.01);联合检测法以及两种单一检测法对于肺癌及其癌前病变的特异性之间比较差异无统计学意义(P>0.05)。结论p16基因启动子甲基化和3p上MSI检测可以作为肺癌的早期诊断指标;联合检测p16基因启动子甲基化和3p上MSI可以显著提高肺癌早期诊断的敏感性同时不降低其特异性,值得临床推广。在肺结核组织中未检测到启动子甲基化和MSI的发生,提示上述两个指标在肺癌和肺结核鉴别困难时是较好的选择。p16基因启动子甲基化和3p上MSI之间无显著相关性,提示二者可能是通过不同的途径对肺癌的发生、发展起作用。Objective To investigate the clinical significance of combined detection of p16 methylation and microsatellite instability (MSI) on 3p in the diagnosis of eraly lung cancer and pulmonary tuberculosis. Methods In lung cancer group,precancerous lesion group, pulmonary tuberculosis group and normal lung tissue group, the p16 methylation was detected by using methylation-specific PCR and the MSI on 3p was detected at four microsatellite loci by using PCR-single strand length polymorphism-EB staining method. Results The ratio of p16 methylation was significantly higher in lung cancer group than in precancerous lesion group (P〈 0.05) and normal lung tissue group(P〈0.01). The ratio of p16 methylation was significantly higher in precancerous lesion group than in normal lung tissue group (P〈0.05). The ratio of MSI was significantly higher in precancerous lesion group than in lung cancer group (P〈0.05) and normal lung tissue group (P〈0.01). The ratio of MSI was significantly higher in lung cancer group than in normal lung tissue group (P〈0.05). There was no methylation and MSI in pulmonary tuberculosis group. The p16 methylation was not associated with MSI(P〉0.05). In the diagnosis of eraly lung cancer, the sensitivity of combined detection of p16 methylation and MSI was significantly higher than that of single detection(P〈0.05) ,but there is no difference in the specificity between combined detection and single detection(P〉0.05). Conclusion The p16 gene methylation and MSI are helpful markers in the diagnosis of early lung cancer. Combined detection of p16 gene methylation and MSI could significantly increase the sensitivity in the diagnosis of early lung cancer. There was no methylation and MSI in pulmonary tuberculosis group, which suggest that the two markers could be used in the differential diagnosis of lung cancer with pulmonary tuberculosis. The p16 methylation is not associated with MSI,which suggest that methylation and MSI impact lung cancer on different
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