P16基因甲基化检测对恶性胸腔积液的诊断价值  

Value of detecting p16 gene methylation in the diagnosis of malignant pleural effusion

作　　者：刘大鹰[1] 周凤丽[2] 胡灼君[1] 胡红波[3] 

机构地区：[1]广西柳州市柳铁中心医院呼吸内科,广西柳州545007 [2]中山大学附属第三医院呼吸科,广东广州510630 [3]广西柳州市柳铁中心医院检验科,广西柳州545007

出　　处：《南方医科大学学报》2010年第9期2148-2150,共3页Journal of Southern Medical University

基　　金：广西壮族自治区科技厅基金(0719006-2-28)

摘　　要：目的检测胸腔积液中沉渣细胞p16基因启动子的甲基化状态,探讨p16基因甲基化检测在良、恶性胸腔积液鉴别诊断中的意义。方法利用甲基化特异性PCR(MSP)方法检测66例原因不明的胸腔积液患者胸水沉渣细胞p16基因的甲基化状态。结果 66例胸腔积液患者中36例确诊为恶性胸腔积液,30例为良性胸腔积液。恶性胸腔积液沉渣细胞p16基因启动子甲基化阳性率为69.4%(25/36);在良性胸腔积液中为13.3%(4/30);经统计学检验良、恶性胸腔积液组胸水沉渣细胞的p16基因甲基化阳性率差异有统计学意义(χ2=20.915,P<0.01)。恶性胸腔积液组沉渣细胞的p16基因异常甲基化阳性率明显高于良性胸腔积液组。恶性胸腔积液组沉渣细胞p16基因甲基化检测的敏感性为69.4%,特异性为86.7%,准确性为77.3%。恶性胸腔积液沉渣细胞p16基因甲基化阳性表达与肿瘤的组织细胞类型及细胞分化程度无关(P均>0.05)。结论 MSP检测胸腔积液中沉渣细胞p16基因启动子的甲基化状态,是一种有潜力的鉴别胸腔积液良、恶性的辅助诊断方法。Objective To investigate aberrant methylation in the promoterof p16 gene in the sediment cells of pleural effusion and evaluate its clinical significance in the differentiating benign and malignant pleural effusion.Methods Using methylation-specific PCR（MSP）,aberrant promoter methylation of p16 gene was detected in the sedimental cells of pleural effusion samples from 66 patients with pleural effusion.Results Of the 66 patients with pleural effusion,36 had a definite diagnosis of malignant pleural effusion,and the rest were confirmed to have benign pleural effusion.The positivity rate of p16 gene promotermethylation was 69.4%（25/36） in malignant pleural effusion and 13.3%（4/30） in benign pleural effusion specimens,showing a significant difference between them（χ2=20.915,P〈0.01）.The diagnostic sensitivity,specificity and accuracy of aberrant promotermethylation of p16 gene in the 36 malignant cases were 69.4%,86.7%and 77.3%,respectively.The positive expression of p16 gene promoter methylation in malignant pleural effusion was not correlated to the histological type or the pathological grade of the tumor（P〉0.05）.Conclusion Detection of aberrant methylation in p16 gene promoterin the sediment cells of pleural effusion specimens by MSP method allows differentiation between benign and malignant pleural effusion.

关 键 词：胸腔积液 DNA甲基化 P16基因 

分 类 号：R730.4[医药卫生—肿瘤]