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目的:荧光定量PCR检测肺癌Lunx基因表达对淋巴结微转移的作用和在各类型肺癌中表达及其与临床分期的关系。方法:42例非小细胞肺癌患者开胸手术纵隔淋巴结提取清除以获取原发灶及纵隔淋巴结病理标本,12例非肿瘤肺叶切除作正常对照。荧光定量PCR检测切除肿块和淋巴结的Lunx mRNA表达。结果:1)肺癌组织和肺良性病变组织中Lunx mRNA表达量分别为1840(328,7210)和237.93(148.45,322.70),P=0.002。2)Ⅲ期肺癌组织中Lunx mRNA表达水平〔2245(280,7210)〕与Ⅰ期的〔1840(1840,7210)〕和Ⅱ期〔328(231,2129)〕差异无统计学意义,χ2=1.4,P=0.497。3)Lunx mRNA在鳞癌和腺癌中的表达水平分别为7210(199,7210)和1202.5(328,2650),P=0.484,该指标与组织类型无关。4)Lunx mRNA为269.5定作界值时,诊断阳性淋巴结的灵敏性为96%,特异度99%。85组淋巴结阳性,57组阴性,42例患者142组区域淋巴结Lunx mRNA阳性59.86%(85/142),HE染色42例患者的50组转移淋巴结阳性35.21%(50/142),明显低于FQ-PCR85枚,P<0.05。表明Lunx mRNA FQ PCR法比常规病理具有更高的敏感性,P<0.05,Kappa值为0.519。5)Spearman等级相关分析显示,LunxmRNA与PET-CT的SUV值关系不大,rs=0.268,P=0.03。结论:FQ-PCR扩增Lunx mR-NA是敏感特异地检测肺癌细胞浸润区域淋巴结的方法。
Objective: To investigate the effect of Lunx gene expression on lymph node micrometastasis in lung cancer by fluorescence quantitative PCR and its relationship with clinical stage in various types of lung cancer. Methods: Thirty-two non-small cell lung cancer patients underwent thoracotomy for mediastinal lymph node dissection to obtain pathological specimens of primary tumor and mediastinal lymph nodes. Twelve non-tumor lobectomy patients were used as normal control. Quantitative real-time PCR detection of lumps and lymph nodes Lunx mRNA expression. Results: 1) The expression of Lunx mRNA in lung cancer tissues and benign lung lesions were 1840 (328,7210) and 237.93 (148.45,322.70), respectively, P = 0.002.2) 280,21210)] had no statistical significance with stage I [1840 (1840,7210)] and stage II (328 (231,2129)], χ2 = 1.4, P = 0.497.3) The expression levels in adenocarcinoma were 7210 (199,7210) and 1202.5 (328,2650) respectively, P = 0.484, which was not related to the type of tissue. 4) When the Lunx mRNA was 269.5 cutoff, the sensitivity for diagnosing positive lymph nodes was 96% and the specificity was 99%. The positive rate of lymph node metastasis in group A was 85.8% (85/142) in 42 cases of 42 cases, and 35.21% (50/142) in metastatic lymph nodes in 42 cases of HE staining, which was significantly lower than that of FQ -85 pieces of PCR, P <0.05. P <0.05, Kappa value was 0.519.5) Spearman rank correlation analysis showed that the LunxmRNA and PET-CT SUV value is not significant, rs = 0.268, P = 0.03. CONCLUSION: FQ-PCR amplification of Lunx mR-NA is a sensitive and specific method for detecting lymph node in lung cancer cell infiltration area.