[Detection of oncogenic mutations in sputum and its diagnostic value of lung cancer]

To find a new method to molecular biological detection of lung cancer.

The sputum specimens from 96 cases of lung cancer and other lung patients were detected for K-ras and p53 mutations by using polymerase chain reaction(PCR) and restriction fragment length polymorphism and and immunohistochemistry (IHC) techniques.

38 out of 62 sputum specimens of lung cancer patients were positive for cytology: Sensitivity was 61%. NPV (negative predictive value) was 59%; p53 was overexpressed in 48 cases: Sensitivity was 77%. NPV was 66%; k-ras was positive in 21 cases: Sensitivity was 34%, NPV 42%; The combination of conventional cytology and molecular screening(k-ras + p53) produced a sensitivity value of 92%(P < 0.05) with an NPV of 84%(P < 0.05); In 24 cases of patients whose cytology of sputum was false negative, 17 were found either p53 or k-ras positive of which 7 patients were identified to be lung cancer in the follow-up study.

These results suggest that detection of oncogene mutation in sputum enhanced and added to the diagnostic value of conventional cytology. It is a promising approach to early lung cancer detection and massive screening in terms of its rapidity, economy and simplicity.