纤维支气管镜联合p16基因甲基化检测对肺癌的诊断价值  

The diagnostic value of fibro-optic bronchoscopy examination combined with detection of aberrant p16 promoter methylation in lung cancer

作　　者：胡灼君[1] 刘大鹰[1] 胡宏波[2] 陈奕平[1] 陈锦平[1] 谭宏春 周锦钢[1] 刘海亮[1] 钟燕[1] 

机构地区：[1]广西柳州市柳铁中心医院呼吸内科,545007 [2]广西柳州市柳铁中心医院检验科,545007

出　　处：《中华全科医师杂志》2010年第5期349-351,共3页Chinese Journal of General Practitioners

基　　金：广西壮族自治区科技厅科研项目（CS055010）

摘　　要：对42例肺癌患者和25例肺部良性病变患者行纤维支气管镜检查，并利用甲基化特异性PCR方法检测外周血血浆、痰液、支气管肺泡灌洗液中p16基因甲基化状态。42例确诊肺癌患者p16基因异常，甲基化阳性数在血浆、痰液和支气管肺泡灌洗液中分别为22例（52．4％）、20例（47．6％）和25例（59．5％），各标本的阳性率差异无统计学意义（P〉0．05）；25例良性病变者中除1例在血液中检测到异常甲基化外，均未检测到p16基因的异常甲基化。经纤维支气管镜确诊25例，敏感度、特异性和准确性分别为59．5％、100．0％和74．6％；纤维支气管镜联合p16基因甲基化检测后敏感度、特异性和准确性分别为92．9％、96．2％和94．0％。Fibro-optic bronchoscopy （FB） examinations were undertaken in 42 cases with lung cancer and 25 cases with benign lung disease; methylation-specific PCR was performed in plasma, sputum and bronchoalveolar lavage fluid （BALF） specimen for detection of p16 gene promoter methylation in all patients. Of the 42 cases of lung cancer, the positive rates of p16 gene promoter methylation were 59.5% in BALF, 52. 4% in plasma and 47.6% in sputum, respectively; while p16 gene promoter methylation was detected only in one plasma sample from 25 cases with benign lung disease （ P 〈 0.05 ）. The sensitivity, specificity and overall accuracy of FB were 59.5%, 100. 0% and 74. 6%, respectively. The sensitivity, specificity and overall accuracy of FB combined with aberrant p16 gene methylation in diagnosis of lung cancer were 92. 9%, 96.2% and 94.0%, respectively. The FB examinations combined with detection of aberrant p16 gene methylation can further improve the accuracy to diagnosis of lung cancer.

关 键 词：支气管镜检查 基因 P16 

分 类 号：R734.2[医药卫生—肿瘤]