作　　者： (张玉华）; (张秀茹）; (李佳）; (何雪）; (李洪利）;

机构地区： 首都医科大学附属北京天坛医院病理科,北京100050

出　　处： 《中国医刊》 2017年第9期91-95,共5页

摘　　要： 目的建立荧光聚合酶链反应(polymerase chain reaction,PCR)快速定性检测胶质瘤MGMT基因启动子甲基化的方法,评价其在指导胶质瘤患者术后个体化化疗及预后判断中的临床应用价值。方法选取2014年3月1日至2015年12月31日于本院手术切除且经病理证实为胶质瘤的石蜡组织样本352例。每例样本均分别进行MGMT甲基化荧光PCR法和甲基化特异性PCR(MSP)方法检测,并设阴性对照、阳性对照与空白对照。比较两种检测方法的一致性和肿瘤组织甲基化检测率。结果 352例标本中有10例不符,最终共有342例检测数据参加统计分析。在342例临床样本中,两组检测结果完全一致的样本有321例,总符合率为93.9%,阳性符合率为95.2%,阴性符合率为91.9%,Kappa值为0.871,差异有显著性(χ2=259.663,P<0.0001)。荧光PCR法的MGMT阳性率为60.53%,MSP法为60.82%。按年龄组及病理类型分层分析,两种检测方法的结果一致。结论荧光PCR与MSP法检测胶质瘤MGMT基因甲基化的结果高度一致,可应用于临床胶质瘤MGMT基因启动子甲基化的定性检测,以指导个体化治疗,有很好的临床应用前景和潜在价值。 Objective To establish a method for rapid qualitative detection of MGMT gene promoter methylation by fluorescence polymerase chain reaction （PCR）, and to explore its feasibility in assessing the clinical value of individualized chemotherapy and prognosis in glioma patients. Method A total of 352 cases of paraffin tissue samples were collected from our hospital from March 1, 2014 to December 31, 2015, which are surgical resection and pathology confirmed glioma. The methylation of MGMT gene was detected by fluorescence PCR and methylation specific PCR （MSP） respectively. The accuracy of the two methods was compared and the detection rate of methylation in tumor tissue was compared. Result In 352 cases, 10 samples did not match, and finally a total of 342 cases of test data to participate in statistical analysis. In 342 cases of clinical samples, there are exactly the same sample of 321 cases and different samples of 21 samples in test results . The total compliance rate was 93.9%, the positive coincidence rate was 95.2%, the negative coincidence rate was 91.9%, and the Kappa value was 0.871, which was statistically significant （χ2=259.663, P〈0.0001）. The positive rate of MGMT was 60.5% in the fluorescence PCR group and 60.8% in the MSP group. Moreover, by age group and pathological type of stratification, the results are consistent. Conclusion A fluorescent PCR method for the detection of MGMT gene methylation in clinical samples, which is highly consistent with the MSP method and can be applied to the qualitative detection of methylation of MGMT gene promoter in clinical gliomas. It can be to guide the individual treatment, and has a good clinical prospects and potential value.

关 键 词： 荧光 胶质瘤 基因 启动子甲基化