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目的 从分子生物学的角度探索端粒酶活性和p16基因甲基化检测对肺癌早期诊断意义。方法 用PCR -TRAP -ELISA半定量及PCR -TRAP银染定性法、甲基化相关的PCR法 ,检测 49例肺癌、2 8例肺部良性疾病的纤维支气管镜后痰液脱落细胞端粒酶活性及p16基因甲基化状态 ,检测结果与组织病理、细胞学进行对照研究。结果 肺癌痰液标本的细胞学敏感性为 5 5 .1% ,特异性为 10 0 % ;端粒酶活性的敏感性为 71.4% ,特异性为 89.3% ;p16甲基化的敏感性为 2 8.6 % ,特异性为 10 0 % ;三者联合检测的敏感性为 90 .9% ,特异性为 89.3%。结论 痰液的细胞学、端粒酶活性表达及p16基因甲基化联合检测可提高肺癌痰检的敏感性 ,有助于肺癌早期诊断。
Objective To explore the significance of telomerase activity and methylation of p16 gene in the early diagnosis of lung cancer from the perspective of molecular biology. Methods PCR-TRAP-ELISA semiquantitative and PCR-TRAP silver staining method, methylation-related PCR, detection of 49 cases of lung cancer, 28 cases of lung benign disease after bronchoscopy sputum exfoliated cells telomerase Activity and p16 gene methylation status, test results and histopathology, cytology control study. Results The cytological sensitivity of lung cancer sputum samples was 51.5% and the specificity was 100%. The sensitivity and specificity of telomerase activity were 71.4% and 89.3%, respectively. The sensitivity of p16 methylation was 2 8.6% and specificity of 10%. The combined detection of the three was 90.9% with a specificity of 89.3%. Conclusion Sputum cytology, telomerase activity and p16 gene methylation detection can improve the sensitivity of sputum examination of lung cancer and contribute to the early diagnosis of lung cancer.