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目的 检测肺癌组织和肺癌患者痰液脱落细胞中p5 3、K ras基因突变情况 ,比较联合检测p5 3、K ras和单一检测p5 3或K ras基因在肺癌诊断中的价值。方法 应用PCR SSCP -银染法检测了 5 9例肺癌组织、癌旁肺组织、14例肺部良性病变肺组织及患者痰液脱落细胞中p5 3基因第 5～ 8外显子、K ras基因第 1外显子突变。结果 肺癌组织中p5 3基因突变率为 37.3 % (2 2 / 5 9) ,痰液脱落细胞为 33 .9% (2 0 / 5 9) ,两组间比较无显著性差异 (P >0 .0 5 )。肺癌组织和患者痰液脱落细胞中K ras基因突变率分别为 2 3 .7% (14 / 5 9)和2 0 .3 % (12 / 5 9)。肺良性病变肺组织和肺良性疾病患者痰液脱落细胞中均未检测到p5 3和K ras基因突变。肺腺癌组织K ras突变率 (44 % ,11/ 2 5 )显著高于其它类型的肺癌 (8.8% ,3/ 34) (P <0 .0 1)。吸烟肺癌患者p5 3突变率 (48.7% ,19/ 39)显著高于非吸烟肺癌患者 (15 % ,3/ 2 0 ) (P <0 .0 1)。联合检测肺癌患者痰液脱落细胞p5 3和K ras基因突变率为 5 4.2 % (32 / 5 9) ,显著高于痰脱落细胞中 33 .9%的p5 3突变和 2 0 .3 %的K ras突变率。结论 联合检测肺癌患者痰液脱落细胞中p5 3和K ras基因突变 ,有助于提高肺癌的检出率和诊断
Objective To detect the p53 and Kras gene mutations in sputum exfoliated cells in lung cancer tissues and lung cancer patients, and to compare the value of combined detection of p53, K ras and single detection of p53 or K ras genes in the diagnosis of lung cancer. Methods PCR-SSCP-silver staining was used to detect the exons 5-8 and Kras gene of p53 gene in 59 lung cancer tissues, adjacent lung tissues, 14 benign pulmonary lesions, and exfoliated cells in patients’ sputum. Exon 1 mutation. Results The mutation rate of p53 gene was 37.3% (22/59) in lung cancer tissues and 33.9% (20/59) in sputum exfoliated cells. There was no significant difference between the two groups (P>0. 0 5 ). The mutation rates of K ras in exfoliated cells in lung cancer tissues and patients were respectively 23.7% (14/59) and 20.3% (12/59). P53 and K ras mutations were not detected in sputum exfoliated cells in patients with lung benign lung disease or benign pulmonary disease. The K ras mutation rate of lung adenocarcinoma tissue (44%, 11/25) was significantly higher than that of other types of lung cancer (8.8%, 3/34) (P < 0.01). The mutation rate of p53 in smoking lung cancer patients (48.7%, 19/39) was significantly higher than that of non-smoking lung cancer patients (15 %, 3/20) (P < 0.01). The combined detection of p53 and K ras gene mutations in sputum exfoliated cells in lung cancer patients was 5 4.2% (32/59), significantly higher than 33.9% of p53 mutations and 20.3% of K in sputum exfoliated cells. Ras mutation rate. Conclusion Combined detection of p53 and K ras gene mutations in exfoliated cells in sputum of lung cancer patients can help improve the detection rate and diagnosis of lung cancer.