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目的 检测肺癌切除组织和支气管切缘P53基因突变 ,了解肺癌手术切除后的效果及局部复发情况。方法 用PCR -SSCP方法将40例肺癌和10例肺部良性肿瘤手术切除标本的支气管切缘 (切缘病理切片无癌细胞残留 ) ,肺癌组织和正常肺组织中的P53基因突变 ,同时对手术后切缘癌复发及转移情况作了随访。结果 12例 (30 % )肺癌支气管切缘和24例肺癌组织存在P53 基因突变 ,至于正常肺组织和良性病变肺组织未发现P53基因突变。本组研究表明 ,肺癌组织P53基因突变以小细胞癌 (98% )最高 ,次为鳞癌 (70% ) ,腺癌(40% ) ,P53基因突变以TNM分期的 ,Ⅲ期 (71.4 % )最高 ,次为Ⅱ期 (58% ) ,Ⅰ期 (26% ) ,术后3～8个月随访 ,支气管切缘P53阳性中5例(41.6% )发生支气管残端复发 ,肺癌组织中P53 阳性有13例 (54% ) ,通过随访发现有癌复发及转移 ;P53 阴性者有3例 (27 % )发现癌复发。两组复发有显著差异 (P<0.05)。结论 本文通过分子检测支气管切缘P53基因突变 ,对早期预测部份肺癌术后残留复发具有重要临床意义。
Objective To detect the mutation of P53 gene in resection tissue and bronchial resection margin of lung cancer, and to understand the effect of local recurrence after lung cancer resection. Methods PCR-SSCP method was used to detect the pharyngeal margin of surgical specimens from 40 cases of lung cancer and 10 cases of lung benign tumors (remaining pathological sections without residual cancer cells), mutation of P53 gene in lung cancer tissues and normal lung tissues. Follow-up margin cancer recurrence and metastasis were followed up. Results P53 gene mutations were found in 12 cases (30%) of lung cancer bronchial resection margins and 24 cases of lung cancer tissues. P53 gene mutations were not found in normal lung tissues and benign lung tissues. In this study, the P53 gene mutation in lung cancer tissues was highest in small cell carcinoma (98%), followed by squamous cell carcinoma (70%), adenocarcinoma (40%), P53 gene mutation in TNM stage, and stage III (71.4%). The highest, followed by stage II (58%), stage I (26%), 3-8 months follow-up, 5 cases (41.6%) of P53 positive bronchial excision margins recurrence of bronchial stump recurrence, lung cancer tissue P53 positive In 13 cases (54%), cancer recurrence and metastasis were found through follow-up; 3 cases (27%) of P53-negative cases had cancer recurrence. There was a significant difference in relapse between the two groups (P<0.05). Conclusion The molecular detection of P53 gene mutation in the bronchial margin has important clinical significance for the early prediction of residual recurrence after partial lung cancer surgery.