纤支镜活检和痰液标本FHIT基因检测对肺癌诊断的意义  

The significance of FHIT gene detection for the diagnosis of lung cancer in transbronchial biopsy tissue samples and sputum samples

作　　者：李殿明[1] 夏雪梅[1] 刘超[1] 陈余清[1] 蔡映云[2] 

机构地区：[1]蚌埠医学院附属医院呼吸病科,233004 [2]复旦大学中山医院呼吸病科,上海市200032

出　　处：《实用医学杂志》2008年第21期3671-3673,共3页The Journal of Practical Medicine

基　　金：安徽省自然科学基金资助项目(编号:03043705)

摘　　要：目的:明确检测肺癌手术标本、纤支镜活检和痰液标本FHIT基因转录本缺失在肺癌诊断中的意义。方法:应用RT-PCR法检测41例肺癌手术标本癌组织和9例良性肺疾病肺组织手术标本以及80例肺癌和30例良性肺疾病纤支镜活检标本及全部的160例患者痰液标本FHIT基因转录本缺失,并与病理组织学、刷检细胞学和痰液细胞学检查结果比较。结果:肺癌组织FHIT基因转录本缺失的阳性率[70.7%(29/41)]高于癌旁正常组织(5/41)和良性肺疾病组织(0/9)(P<0.005);纤支镜活检标本FHIT基因转录本缺失阳性率[70.0%(56/80)]高于良性肺疾病(2/30)(P<0.005);痰液FHIT基因转录本缺失联合痰液细胞学检查诊断肺癌的敏感性(73.6%)高于单独痰液细胞学(47.1%)或痰液中FHIT基因转录本缺失(52.1%)(均P<0.005)。与单独痰液细胞学相比,两者联合检测使诊断肺癌的敏感性由原来的47.1%提高至73.6%(P<0.005),阴性预测值由原来的37.9%提高至54.9%(P>0.05),特异性不变。结论:在肺癌组织中检测FHIT基因转录本缺失可能成为肺癌诊断的分子标志物之一。痰液中FHIT基因转录本缺失检测为肺癌无创诊断提供了一个新的辅助指标。Objective To explore the significance of FHIT gene transcript deletion in the diagnosis of lung cancer by detecting the FHIT gene in transbronchial biopsy samples and sputum samples. Methods FHIT gene transcript deletion was detected by RT-PCR in 41 resected surgical specimens of lung eancer and its adjacent normal tissue and 9 of benign pulmonary diseases, 80 transbronchial biopsy samples of lung cancer and 30 of benign pulmonary diseases, and all sputum samples of these 160 patients. The results were compared with the findings of pathohistologieal examination and cytological examinations of the whole endobronehial brush and the sputum. Results The rate of FHIT gene transcripts deletion in the resected lung cancer tissues was higher than that in the adjacent normal tissues and the benign pulmonary tissues （70.7% vs 12.2% and 70.7% vs 0%, P 〈 0.005）. For transbronchial biopsy, the rate of FHIT gene transcripts deletion in the cancer tissues was higher than that in the benign tissues （70.0% vs 6.7%, P 〈 0.005 ）. The sensitivity of diagnosis with detection of FHIT gene transcripts deletion in sputum combined with cytological examination of the sputum was increased, as eompared with that of either examination alone, from 47.1% to 73.6% （P 〈 0.005）. The negative predietive value elevated from 37.9% for sputum cytology alone to 54.9% for the combined detection. No change in the specificity occurred. Conclusions FHIT gene transcripts deletion in lung cancer tissues may be regarded as one of the biomarkers for indicating lung cancer. Detection of FHIT gene transcripts deletion in sputum provides a new, noninvasive approach for diagnosing lung cancer.

关 键 词：肺肿瘤 逆转录聚合酶链反应 FHIT 纤支镜活检 痰标本 

分 类 号：R734.2[医药卫生—肿瘤]