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目的研究3p、9p微卫星DNA异常在肺癌早期诊断中的价值。方法应用PCR-银染法从外周血检测105例原发性肺癌及9例肺部良性疾病3p14、3p21、9p21上的3个微卫星位点(D3S1228、D3S1029、D9S171)的异常表现。结果肺癌患者血清中DNA含量多于良性病变患者。肺癌组各微卫星位点的微卫星不稳症(MSI)或微卫星杂合性缺失(LOH)异常的阳性率为43%～50%,以D3S1029最高,达49.6%,3个位点中至少1个位点出现微卫星异常者占76.2%,其中45.7%呈多位点改变,同肺良性病变组比较有显著性差异(P﹤0.05)。肺癌组中各微卫星位点的异常表现与肺癌临床分期和临床病理类型之间无显著相关性(P﹥0.05)。结论3p、9p微卫星DNA异常和肺癌分期无关,可以作为一项肺癌早期基因检测的新途径。不同微卫星位点出现异常表现的具体形式有所不同,多位点联合检测可以提高诊断的敏感性和特异性。
Objective To investigate the value of 3p and 9p microsatellite DNA abnormalities in the early diagnosis of lung cancer. Methods The abnormalities of three microsatellite loci (D3S1228, D3S1029 and D9S171) in 105 primary lung cancer and 9 pulmonary benign diseases 3p14, 3p21 and 9p21 were detected by PCR-silver staining. Results Lung cancer patients with more DNA than benign lesions. The positive rates of microsatellite instability (MSI) or microsatellite heterozygosity (LOH) abnormalities in each microsatellite locus in lung cancer group were 43% ~ 50%, highest in D3S1029 (49.6%), Microsatellite abnormalities occurred in at least 1 locus, accounting for 76.2%, of which 45.7% showed multiple loci changes, which were significantly different from those in benign pulmonary lesions (P <0.05). There was no significant correlation between the abnormality of microsatellite loci and clinical stage and clinicopathological types of lung cancer (P> 0.05). Conclusion The microsatellite DNA abnormalities of 3p and 9p are not related to the staging of lung cancer, which may serve as a new way to detect the early gene of lung cancer. Different forms of microsatellite abnormalities appear in different forms of specific, multi-site joint detection can improve the diagnostic sensitivity and specificity.