摘要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.

abstractsObjectives 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.