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The Value of Detecting Alteration Genes Alteration in Sputum Specimens for the Early Diagnosis of Lung Cancer

Wu Xiao jun,Ding Xu hong,Hu Ke,et al Department of Respiratory Medicine,Renmin Hospital,Wuhan University,Wuhan 430060,China  
Objectives:To assess the value of detecting the changes of P53,K ras ,P15,and P16 genes combined together for the early diagnosis of lung cancer.Methods:PCR SSCP silver staining was applied to detect mutations of 5~8 exon of P53 gene in 59 lung cancer cases and 14 patients with benign respiratory diseases.Their corresponding sputum specimens were also studied.The mutations of the first exon of K ras gene in 25 cases with lung adenocarcinoma and 14 cases with benign respiratory diseases were etected by PCR RFLP.The homozygous deletion of P15 and p16 gene was detected by PCR in all the lung cancer biopsies and benign control and their relevant sputum.Results:The frequency of P53,P15 and P16 alteration Was 37.3%,11.9% adn 23.8% respectively and only one case with benign respiratory disease showed P16 homozygous deletion.The changes of P53, K ras, P15 and P16 gene showed no difference in the biopsy specimens and corresponding sputum specimens.The relationship of P53 and K ras mutations with smoking status was also discussed.The mutation rates of P53 and K ras in smokers were 48.7% and 68.5%, while in non smokes were 15% and 11.1%.The mutation rates of P53 and K ras in smokers were higher than those in non smokers,P0.01.The value of these four markers used together for the early diagnosis of lung cancer was also assessed,the result showed that the sensitivity of four markers combined(78%) was obviously higher than that of any single gene detection.Conclusion:The changes of P53,K ras,P15 and P16 are common in lung cancer.Four markers used together are better than any single marker changes for the early diagnosis of lung cancer.Detection of multiple genes alteration in sputum of high risk population may be helpful for the early diagnosis of lung cancer.
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