评价肺部样本中的支气管镜检查在肺癌分子分析中的作用。
Evaluation of lung flute in sputum samples for molecular analysis of lung cancer.
机构信息
Departments of Pathology, University of Maryland School of Medicine, 10 South Pine Street, MSTF 7th floor, Baltimore, MD 21201-1192, USA.
出版信息
Clin Transl Med. 2013 Sep 22;2(1):15. doi: 10.1186/2001-1326-2-15.
BACKGROUND
Molecular analysis of sputum provides a promising approach for lung cancer diagnosis, yet is limited by the difficulty in collecting the specimens from individuals who can't spontaneously expectorate sputum. Lung Flute is a small self-powered audio device that can induce sputum by generating sound waves and vibrating in the airways of the lungs. Here we propose to evaluate the usefulness of Lung Flute for sputum sampling to assist diagnosis of lung cancer.
METHODS
Forty-three stage I lung cancer patients and 47 cancer-free individuals who couldn't spontaneously cough sputum were instructed to use Lung Flute for sputum sampling. Expressions of two microRNAs, miRs-31 and 210, were determined in the specimens by qRT-PCR. The results were compared with sputum cytology.
RESULTS
Sputum was easily collected from 39 of 43 (90.7%) lung cancer patients and 42 of 47 (89.4%) controls with volume ranges from 1 to 5 ml (median, 2.6 ml). The specimens had less than 4% oral squamous cells, indicating that sputum was obtained from low respiratory tract. Expressions of miRs-31 and 210 in sputum were considerably higher in cancer patients than cancer-free individuals (8.990 vs. 4.514; 0.6847 vs. 0.3317; all P <0.001). Combined use of the two miRNAs produced a significantly higher sensitivity (61.5% vs. 35.9%, P = 0.002) and a slightly lower specificity (90.5% vs. 95.2%, p = 0.03) compared with cytology for lung cancer diagnosis.
CONCLUSION
Lung Flute could potentially be useful in convenient and efficient collection of sputum for molecular diagnosis of lung cancer.
背景
痰液的分子分析为肺癌诊断提供了一种很有前景的方法，但由于难以从无法自主咳痰的个体中采集标本，其应用受到限制。 Lung Flute 是一种小型自供电音频设备，通过产生声波并在肺部气道中振动来诱导痰液产生。在这里，我们提出评估 Lung Flute 用于痰液采样以辅助肺癌诊断的有用性。
方法
我们指导 43 例 I 期肺癌患者和 47 例无法自主咳痰的无癌症个体使用 Lung Flute 进行痰液采样。通过 qRT-PCR 确定标本中两种 microRNA（miRs-31 和 210）的表达。将结果与痰液细胞学检查进行比较。
结果
39 例（90.7%）肺癌患者和 42 例（89.4%）对照组中有 39 例（90.7%）和 42 例（89.4%）患者能够轻松地使用 Lung Flute 采集痰液，其体积范围为 1 至 5ml（中位数，2.6ml）。标本中口腔鳞状细胞少于 4%，表明痰液来自下呼吸道。与无癌症个体相比，癌症患者的痰液中 miR-31 和 210 的表达明显更高（8.990 与 4.514；0.6847 与 0.3317；均 P<0.001）。与细胞学相比，两种 microRNA 的联合使用可显著提高肺癌诊断的敏感性（61.5% 比 35.9%，P=0.002），并略微降低特异性（90.5% 比 95.2%，P=0.03）。
结论
Lung Flute 可能有助于方便、有效地采集痰液，用于肺癌的分子诊断。
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