摘要
目的 :研究CT扫描与肺活检后痰液脱落细胞的端粒酶活性和p16甲基化检测对早期周围型肺癌的诊断意义。方法 :用PCR TRAP ELSA半定量及PCR TRAP银染定性法、甲基化相关的PCR法 ,前瞻性检测 5 5例经CT扫描而发现的肺部孤立性结节 (直径≤ 30mm)、并疑诊为早期周围型肺癌的患者 (T1N0 M0 ) ,行CT导向肺活检 (纤维支气管镜肺活检 33例 ,经皮肺针刺活检 2 2例 )后 2 4h内痰液脱落细胞端粒酶活性及p16甲基化状态 ,并将检测结果与组织病理进行对照研究。结果 :CT扫描对周围型肺癌诊断的敏感性为 10 0 % ,但特异性只有 6 1 8% (34/ 5 5 )。端粒酶活性的敏感性为 79 4 % ,特异性为 90 5 % ,准确性为 83 6 % ;p16甲基化的敏感性为 32 4 % ,特异性为 10 0 % ,准确性为 5 8 2 % ,3者联合检测的敏感性为 86 1% ,特异性为 90 5 % ,准确性为 87 3%。对照组端粒酶阳性率 9 5 % (2 / 2 1) ,无1例检测到p16甲基化。结论 :CT扫描与端粒酶活性、p16甲基化联合可弥补痰液的细胞学检查的不足 ,提高肺癌痰检的敏感性 。
Objective To investigate the diagnostic value of telomerase activity and p16 gene methylation from exfoliated cells of sputum in 55 cases of solitary nodules suspected early peripheral lung cancer.Methods The specimens from 34 cases of cancer nodes and 21 cases of benign lung lesion were detected for telomerase activity and p16 gene methylation by methylation analysis.Results The qualitative diagnosis accuracy of CT scan was 61.8%(34/55)for peripheral lung cancer.Telomerase activity was positive in 29 cases:the ensitivity was 79.4%,the specificiy was 90.5%,the accuracy was 83.6%;p16 gene methylation was 11 cases:the sensitivity was 32.4%,the specificity was 100%,the accuracy was 58.2%.The sensitivity was increased to 86.1% by combination of telomerase activity and p16 gene methylation.Conclusions The results suggest that combining CT scan with telomerase activity and p16 gene methylation detection in sputum of patients with lung cancer may enhance the diagnostic value of conventional cytology.It is a promising approach to early diagnosis of lung cancer and massive screening in terms of its rapidity,economy and simplicity.
出处
《肿瘤防治杂志》
2002年第5期497-500,共4页
China Journal of Cancer Prevention and Treatment
基金
江苏省自然科学基金 (BJ98110 )
江苏省卫生厅重点课题基金 ( 980 8H )资助
