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目的探讨支气管灌洗液(BLF)标本Survivin m R N A检测在肺癌尤其是周围型肺癌诊断中的可行性及应用价值。方法应用逆转录-聚合酶链反应(R T-PC R)方法,分别检测124例肺癌、103例支气管肺部良性疾病患者BLF标本Survivin m R N A表达情况,并与BLF标本细胞病理学等结果相比较。结果 BLF标本Survivin m R N A表达阳性率肺癌患者45.2%(56/124),显著高于支气管肺部良性疾病患者18.4%(19/103),差异有统计学意义(χ2=18.150,P=0.000)。BLF标本Survivin m R N A相对表达量与肺癌病理类型、分化程度均相关(均P<0.05);而与肺癌患者的性别、年龄、抽烟史、肿瘤的部位、大小、淋巴结转移、远处转移、临床分期及中心型肺癌患者BLF方式之间均无明显相关(均P>0.05)。BLF标本检测Survivin m R N A诊断肺癌的敏感性、特异性分别为45.2%(56/124)和81.6%(84/103),诊断周围型肺癌的敏感性、特异性分别为35.9%(14/39)和85.4%(88/103)。BLF标本检测Survivin m R N A表达联合细胞病理学检查阳性率为57.5%(65/113),显著高于单独检测Survivin m R N A阳性率43.4%(49/113)或细胞病理学阳性率23.9%(27/113),差异均有统计学意义(χ2=4.531,26.472,P=0.033,0.000)。结论 BLF标本Survivin m R N A可能成为肺癌诊断有价值的肿瘤标志物之一,为肺癌尤其是周围型肺癌早期诊断提供帮助,BLF标本获取方式不影响Survivin m R N A表达检测结果。
Objective To investigate the feasibility and value of Survivin m R N A detection in bronchial lavage fluid (BLF) specimens in the diagnosis of lung cancer, especially peripheral lung cancer. Methods The expression of Survivin m RNA in BLF specimens of 124 patients with lung cancer and 103 patients with benign bronchopulmonary disease was detected by reverse transcription polymerase chain reaction (RT-PCR). The results were compared with those of BLF specimens Compare Results The positive expression rate of Survivin m RNA in BLF specimens was 45.2% (56/124) in lung cancer patients, which was significantly higher than that in benign lung diseases patients (18.4%, 19/103) (χ2 = 18.150, P = 0.000) . The relative expression of Survivin m RNA in BLF specimens was correlated with the pathological type and differentiation of lung cancer (all P <0.05), but not with the gender, age, smoking history, tumor location, size, lymph node metastasis, distant metastasis There was no significant correlation between BLF mode of staging and central lung cancer patients (all P> 0.05). The sensitivity, specificity and specificity of Survivin m RNA in diagnosing lung cancer were 45.2% (56/124) and 81.6% (84/103) respectively in BLF specimens. The sensitivity and specificity of BLF specimens in diagnosing peripheral lung cancer were 35.9% (14/39 ) And 85.4% (88/103). The positive rate of Survivin m RNA expression detected by BLF in combination with cytopathology was 57.5% (65/113), which was significantly higher than that of Survivin m RNA in 43.4% (49/113) or cytopathology (23.9%) / 113), the differences were statistically significant (χ2 = 4.531,26.472, P = 0.033,0.000). Conclusion Survivin m R N A may be one of the valuable tumor markers for the diagnosis of lung cancer. It is helpful for the early diagnosis of lung cancer, especially for peripheral lung cancer. The BLF specimen acquisition method does not affect the expression of Survivin m R N A.