p53、p21waf1和增殖细胞核抗原诊断肺癌的评估  

Evaluation of p53,p21waf1,and PCNA in the diagnosis on lung cancer

作　　者：丁续红[1] 杨炯[1] 胡苏萍[1] 吴小军[1] 李清泉[1] 

机构地区：[1]湖北医科大学附属第一医院呼吸内科,武汉430060

出　　处：《中华流行病学杂志》2001年第1期54-57,共4页Chinese Journal of Epidemiology

基　　金：湖北省自然科学基金资助项目!(96J0 70 )

摘　　要：目的　评价 p5 3、p2 1waf1和增殖细胞核抗原 (PCNA)蛋白表达对肺癌的诊断价值。 方法　采用免疫组化法检测 114例肺癌和 89例肺良性疾病组织标本p5 3、p2 1waf1和PCNA蛋白表达状况 ,计算三项指标及其组合诊断肺癌的各项参数。结果　 (1)肺癌 p5 3、p2 1waf1及PCNA表达阳性率分别为 47.37%、75 .44 %和 80 .70 % ,明显高于肺良性疾病组织 (P <0 .0 0 1)。其OR值分别为39 .15 ,5 .75和 6 .76。 (2 ) p5 3、p2 1waf1及PCNA蛋白表达与肺癌TNM分期无关。不同病理类型 p5 3和 p2 1waf1蛋白表达也无差异 ,但鳞癌PCNA表达阳性率高于小细胞癌。 (3) p5 3诊断肺癌的阳性似然比为 2 1.0 8,高于p2 1waf1和PCNA ,但灵敏度较低。 (4 )PCNA诊断鳞癌的Youden指数为 0 .5 146 ,显著高于小细胞癌。但其阳性似然比为 2 .2 9,仍低于 p5 3。 (5 ) p5 3和PCNA平行试验的灵敏度为89 .47% ,特异度为 6 0 .6 7% ,其综合评价参数最高。结论　 (1)肺癌p5 3、p2 1waf1和PCNA表达均上调 ,三者与肺癌均有很强联系。 (2 ) p5 3是一项很好的肺癌诊断单项指标。p5Objective To evaluate the diagnostic value of p53, p21waf1 and PCNA on diagnosis of lung cancer. Methods One hundred and fourteen lung cancer patients and 89 cases with benign pulmonary diseases were studied on the expression of p53, p21waf1 and PCNA by immunohistochemical staining. The differences of p53, p21waf1 and PCNA expression status between these two groups were compared and the diagnostic value of these three markers was evaluated.Results (1) The positive rates of p53, p21waf1 and PCNA expression in lung cancer were 47.37 %, 75.44 % and 80.70 %,all significantly higher than that in benign pulmonary diseases( P < 0.001 ), with odds ratio 39.15 , 5.75 , 6.76 respectively. (2)The positive likelihood ratio of p53 was 21.08 , higher than that of p21waf1 and PCNA. Specificity and Youden index were also higher than those of p21waf1 and PCNA, but the sensitivity of p53 was low. (3) The sensitivity and specificity of p53 and PCNA parallel test were 89.47 % and 60.67 % respectively. Conclusions (1) The expression of p53, p21waf1 and PCNA in lung cancer cases were all upregulated. These three markers all seemed to have strong links with lung cancer. (2) p53 was shown a good marker for lung cancer diagnosis. (3) The diagnostic value of p53 and PCNA parallel test was rather high.

关 键 词：肺肿瘤 增殖细胞核抗原 P53基因 P21WAF1 诊断 

分 类 号：R734.2[医药卫生—肿瘤]