【摘要】 目的　探讨粪便p5 3基因突变检测对结直肠癌的诊断价值 ,旨在建立一种非侵入性的结直肠癌筛检的方法。方法　应用PCR 单链构象多态性分析 溴乙锭染色方法 ,检测 4 0例结直肠癌、2 0例结直肠腺瘤及 15例胃癌患者肿瘤组织和粪便标本 p5 3基因突变。 结果　 4 0例结直肠癌患者粪便 p5 3相应外显子DNA片段扩增率为 90 % ,2 0例结直肠腺瘤为 85 % ,15例胃癌为 93%。所有标本总的扩增率为 89%。 4 0例结直肠癌患者组织标本中 2 9例存在 p5 3突变 (72 5 % ) ,其中 2 3例粪便测及p5 3突变 ,检测敏感性为 5 7 5 % ,明显高于粪便隐血及血癌胚抗原检测的阳性率 (P <0 0 5 ) ;2 0例结直肠腺瘤患者组织标本中 3例存在 p5 3突变 (15 0 % ) ,且均测及粪便p5 3基因突变。 15例胃癌患者组织标本中 10例存在 p5 3突变 (6 7 7% ) ,粪便均未测及 p5 3突变。结论　粪便 p5 3基因突变检测诊断结直肠癌的敏感性较高 ,有望成为早期诊断大肠癌的一个相对敏感、特异、有效的指标 ,尤其在大范围人群筛检时。更多还原

【Abstract】 ObjectiveTo explore the value of analysis of p53 gene mutation in fecal specimen in the diagnosis of colorectal carcinoma (CRC) in order to establish a non-invasive method for the screening of CRC. MethodsThe status of p53 gene mutation of the tumor tissues and corresponding fecal specimens was analyzed by polymerase chain reaction-single strand configuration polymorphism with EB staining in 40 CRC,20 colorectal adenoma and 15 gastrocarcinoma. ResultsAmplification rates of fecal p53 gene were 90%,85% and 93% in 40 CRC,20 colorectal adenoma and 15 gastrocarcinoma,respectively. Total amplification rate was 89%. p53 gene mutation in tumor tissue was detected in 29 of 40 cases of CRC,23 cases of which had p53 mutation in fecal specimens with the diagnostic sensitivity rate of 57.5%. Analysis of fecal p53 gene mutation had relatively higher diagnostic sensitivity rate than the detection of serum carcinoembryonic antigen and fecal occult blood ( P <0.05) for the diagnosis of CRC. 3 of 20 colorectal adenoma had p53 mutation both in tumor tissues and fecal specimens. 10 of 15 gastrocarcinoma had p53 mutation in tumor tissues but none in fecal specimens. ConclusionsAnalysis of fecal p53 gene mutation has relatively higher diagnostic sensitivity rate for diagnosis of CRC and is expected to be a relatively sensitive,specific and effective method for early diagnosis of CRC,especially for CRC screening in large scale of the population.更多还原