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目的 :研究癌性胸水 p16基因纯合性缺失检测的临床意义。 方法 :应用PCR技术检测胸水 p16基因第一、二外显子纯合性缺失 ,并结合胸水脱落细胞学检测分析其在临床诊断中的意义。结果 :表明所检 31例肺癌所致癌性胸水标本中均无出现 p16基因第一外显子纯合性缺失 ,12例有p16基因第二外显子纯合性缺失 ,阳性率为 38 71% (12 / 31)。 16例脱落细胞学检测阳性 ,阳性率为 5 1 6 2 % (16 / 31) ;15例脱落细胞学检测阴性 ,其中 6例存在p16基因第二外显子纯合性缺失 ;两者联合检测 ,阳性率提高至 70 97% (2 2 / 31)。统计学分析表明 p16基因第二外显子纯合性缺失和脱落细胞学检测阳性率间无明显差异 ,而两者联合阳性检出率明显高于单独p16基因第二外显子纯合性缺失 (P <0 0 1)和脱落细胞学检测 (P <0 0 1)。 2 1例结核性胸水中均无胸水 p16基因纯合性缺失。结论 :本组资料说明胸水 p16基因第二外显子纯合性缺失与脱落细胞学联合检测可增加诊断的阳性率 ,并补充和提高胸水脱落细胞学的诊断价值
Objective: To study the clinical significance of the detection of homozygous deletion of p16 gene in cancerous pleural effusion. Methods: PCR technique was used to detect the homozygous deletion of exon1 and exon of p16 gene in pleural effusion, and its significance in clinical diagnosis was analyzed in combination with pleural effusion cytology. Results: The results showed that there was no homozygous deletion of exon 1 of p16 gene in 31 cases of lung cancer and 12 cases of homozygous deletion of p16 gene, the positive rate was 38 71% (12/31). 16 cases of exfoliative cytology test positive, the positive rate was 51.62% (16/31); 15 cases of exfoliated cytology was negative, of which 6 cases of p16 gene exon 2 homozygous deletion; the two combined detection , The positive rate increased to 70 97% (2 2/31). Statistical analysis showed that there was no significant difference between the homozygous deletion of exon 2 of p16 gene and the positive rate of exfoliated cytology, but the positive rate of the combined detection of p16 gene was significantly higher than that of the second exon of p16 gene (P <0.01) and exfoliated cytology (P <0.01). There was no homozygous deletion of p16 gene in 21 cases of tuberculous pleural effusion. Conclusion: The data of this group indicate that the combined detection of exon 2 exon 2 and exfoliative cytology in pleural fluid may increase the positive rate of diagnosis, and supplement and improve the diagnostic value of pleural effusion cytology