周围型肺癌的早期诊断-CT扫描结合痰液肿瘤标志物检测.pdfVIP

重庆医科大学学报2(隅盖在第 33 卷第 10弱 (Joumal of Ch∞gqi罚gMedi倒出拥rsity 氢踹. VoI.33 NO.I01 论薯文章编号:也53-3626(2制 )10-1193书 周罔型肺癌的早期诊断-CT 扫描结合痪液 肿瘤标志物检测 曹爱红 1，王绪 2，石红建 1 - 1193 - (1.东南大学院属中大医院放射科，南京 21αlO9 ;2徐州医学院第二黯属医皖放射科，徐州 221α后} i搞 要}目的:研究 CT扫描与前活检后痰液脱落细胞的端粒酶活性和 p16 甲基先检翻对早期周围型肺癌的诊断意义。方法z 用 PCR-四AP-EUSA 半定量及 PCR-姐姐银染定性法、甲基化相关的 PCR 法，前瞻性捡褂 55 偶经 CT 扫描而发现的黯部孤 立性结节(直径运30 mm)、并疑诊为早期周围型肺癌(T，NoMo) ，行 CT 导向藤活检(纤维支气管镜肺活检 33 例，经皮膀针剌活检 22 例}后 24h 内痰液税落细胞端粒酶活性及 p16 甲基住状态，并将检测结果与组织病理进行对照研究。结果:CT 扫描对周南望 肺癌诊断的敏感性为 U)(胁，值特异性只有 61.8%( 34155)。端粒酶活性的敏感性为 79.49昏，特异性为 90.5%，准确性为 83.6%; pl6 甲基化的敏感性为 32.4%，特异性为 1∞%，准确性为 58.2%;三者联合检测的敏惑性为 86.1%，特异性为 90.5%，准确性为 87.3%。对照组端粒酶国性率 9.5%(2尼日，无 l 例检捕到 p16 甲基化。结论:CT 扫描与墙粒藕活性、p16 甲基也联合检醋可弥 补痰液的细胞学检查的不足，提高精癌痰撞的敏感性，有助于周围型黯癌早期诊断和黯部孤立性结节的鉴别诊断。 【关键词]肺肿瘤:痰液:端垃酶;p16 甲基化 【中国图书分类法分类号lR782.4 【文献标氓属】A 【收稿日期 J2∞8-07-(狼 The value of CT scan and tumor markers in sputum for early diagnosis 01 peripheral lung cancer CAO Ai-hong,et al (Dep础nent 01 Radiology ，品ongda Hospital ,sOlúhea.st University) 【 A捡回到) Objective:To i昆明电班 the di唔10Stic value of telomera配 activity and p16 gene methylation from exfoliated cells of 8putum in 55 c暗自8 of solita巧 nodules and of heing 8U8p配tOO of 臼rly peI兰pheral lung cancer (T1NoMo). Me拢。ds:霄1e 8pU饱m 8pecim创18 from 34 cases of 明ncernod回回d 21 cases of hen增1 lung lesion were de始cted for telomerase 街创ty and p16 g四e methylation by methylation 皿alysis. Re军ults: The 年talitative 也帮阴is 配curacy of CT scan was 61.8% (34155) for peripheral lung 饵ncer. Telomerase 配tivi句 was 萨践挝ve in 29 ca甜8:Sensitivity w豁 79.4%;Specíficity was 9O.5%;and 优curacy was 83.6%. p16 gene methylation was in 11 cas臼:Sensi即ity was 32.4%; speci盗city was 1锁)0/0 ， 阻d veracity was 58.2%. The sensitivity was 脆把部ed to 86.1% by the ∞mbina岳阳。，f telomerase activity and p16 gene 匹克thylatiion. C∞clusion: 古1e results 8U段~st 也at ∞mbining CT scan with tel创ner部e activity and p16 gene methylati咽 detection in sputum for patients with lung C扭cer may enhance 由e dia伊ostic value of conventional cytol