肺泡灌洗液p16、MGMT、FHIT和APC甲基化对肺癌早期筛查的价值  

The Value of Combined Detection p16,MGMT,FHIT and APC Gene Methylation in A lveolar Lavage Fluid of Patients with Pulmonary Nodules for Lung Carcinoma Early Screening

作　　者：王月花[1] 宋昱晨[1] WANG Yuehua;SONG Yuchen(The People's Hospital of Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市人民医院,浙江金华321000

出　　处：《浙江医学教育》2020年第2期57-60,共4页Zhejiang Medical Education

基　　金：金华市科技局资助课题(编号:2018-4-055)。

摘　　要：目的:检测肺结节患者肺泡灌洗液中抑癌基因p16、MGMT、FHIT和APC的甲基化,探讨它们在肺癌早期诊断中的价值。方法:收集100例肺结节患者的肺泡灌洗液标本,根据手术结果分为2组,肺癌(浸润型腺癌、微浸润型腺癌、原位癌)或癌前病变(腺瘤样不典型增生)为实验组,良性病变为对照组,采用MSP方法检测患者p16、MGMT、FHIT和APC基因的启动子DNA的甲基化。采用χ^2检验、ROC曲线分析p16、MGMT、FHIT和APC基因甲基化对肺癌诊断的价值。结果:肺癌及癌前病变甲基化率明显高于良性病变组(P<0.05)。ROC曲线发现单个抑癌基因甲基化检测灵敏度和特异度均在50%以上,但四者联合检测灵敏度和特异度在90%以上,约登指数0.87。结论:p16、MGMT、FHIT和APC基因甲基化均为肺癌发生的危险因素;联合检测肺泡灌洗液p16、MGMT、FHIT和APC基因甲基化可提高肺结节患者肺癌早期筛查的准确性。[Objective]To detect the methylation of tumor suppressor genes p16,MGMT,FHIT and APC in alveolar lavage fluid of patients with pulmonary nodules,and to explore their value in the early diagnosis of lung carcinoma.[Method]100 cases of patients with pulmonary nodules alveolar lavage fluid specimens were collected.According to the results of surgery,the specimens were divided into 2 groups,the lung cancer(infiltrating adenocarcinoma,micro invasive adenocarcinoma,carcinoma in situ)or precancerous lesions(dysplasia adenoma sample)as the experimental group and benign lesions as control group.P16,MGMT,FHIT and APC gene promoter methylation of DNA were detected with MSP method.The value of above gene methylation was analyzed by 2 test and ROC curve.[Result]The methylation rates of infiltrating adenocarcinoma,micro-infiltrating adenocarcinoma,in situ carcinoma and adenomatous atypical hyperplasia were significantly higher than those of benign lesions(P<0.05).ROC curve showed that the detection sensitivity and specificity of methylation of single tumor suppressor gene were above 50%,but the detection sensitivity and specificity of the combined detection of the four genes were above 90%,and the yoten index was 0.87.[Conclusion]P16,MGMT,FHIT and APC gene methylation wererisk factors for lung carcinoma.Combined detection of alveolar lavage fluid p16,MGMT,FHIT and APC gene methylation can improve the accuracy of early lung cancer screening in patients with pulmonary nodules.

关 键 词：肺结节 肺泡灌洗液 P16 MGMT FHIT APC 甲基化 

分 类 号：R734.2[医药卫生—肿瘤]