CAJ | 학술논문

目的评价痰标本检测p53基因点突变方法及其作为肺癌早期临床诊断监测指标的真实性和可靠性.方法用PCR-SSCP-银染法检测54例原发性肺癌患者和114例良性肺疾患者痰标本中p53基因第5-8外显子的点突变,同时进行痰涂片细胞学检查.结果 p53突变在肺癌组检出率为55.56% (30/54),非肺癌组检出率为1.75% (2/114) (P<0.001).痰标本检测p53基因突变作为肺癌临床诊断监测指标的灵敏度55.56%、特异度98.25%、阳性似然比31.75.肺癌组p53阳性检出率55.56% (30/54)与痰涂片瘤细胞阳性检出率35.19% (19/54)比较:差异性有显著意义 (P<0.05),关联性有极显著意义 (P<0.01).肺癌组p53检出率与性别、吸烟指数、病理分型、疾病分期均无明显关系,但与年龄有密切关系,高龄患者(60岁)检出率高(P=0.02).非肺癌组一例慢性阻塞性肺病(COPD)患者检测到E5突变,随访四年,确诊为肺鳞癌.结论 PCR-SSCP-银染法检测痰标本p53突变可以在可疑肺癌患者(如吸烟者合并慢性肺疾患)中作为一项随访监测指标,将有助于肺癌早期临床诊断.
목적평개담표본검측p53기인점돌변방법급기작위폐암조기림상진단감측지표적진실성화가고성.방법용PCR-SSCP-은염법검측54례원발성폐암환자화114례량성폐질환자담표본중p53기인제5-8외현자적점돌변,동시진행담도편세포학검사.결과 p53돌변재폐암조검출솔위55.56% (30/54),비폐암조검출솔위1.75% (2/114) (P<0.001).담표본검측p53기인돌변작위폐암림상진단감측지표적령민도55.56%、특이도98.25%、양성사연비31.75.폐암조p53양성검출솔55.56% (30/54)여담도편류세포양성검출솔35.19% (19/54)비교:차이성유현저의의 (P<0.05),관련성유겁현저의의 (P<0.01).폐암조p53검출솔여성별、흡연지수、병리분형、질병분기균무명현관계,단여년령유밀절관계,고령환자(60세)검출솔고(P=0.02).비폐암조일례만성조새성폐병(COPD)환자검측도E5돌변,수방사년,학진위폐린암.결론 PCR-SSCP-은염법검측담표본p53돌변가이재가의폐암환자(여흡연자합병만성폐질환)중작위일항수방감측지표,장유조우폐암조기림상진단.
Objectives To evaluate the value of detecting p53 gene point mutations in sputum samples and its validity and reliability as a surveillance index in the early diagnosis of lung cancer in suspicious patients.Methods Sputum samples were collected from 54 cases identified as lung cancer and 114 cases identified as pulmonary benign disease. The polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was performed for the detection of point mutations at exons 5-8 of the p53 gene, and sputum smears were also used for each sample. Conclusion Detection of p53 gene alterations in sputum samples by PCR-SSCP-silver stain can be used as a follow-up surveillance index for the early diagnosis of lung cancer in suspicious patients.