乳腺癌患者外周血CK-19 mRNA检测临床意义.docVIP

乳腺癌患者外周血CK-19 mRNA检测临床意义[摘要] 目的 探讨外周血CK-19 mRNA表达与乳腺癌的关系,评价其在乳腺癌诊断上的价值。方法 应用RT-PCR技术检测200例乳腺癌患者外周血中CK-19 mRNA表达情况,并以66例乳腺良性疾病和60例正常健康女性作为对照。结果 200例乳腺癌患者48例外周血CK-19为阳性,66例乳腺良性疾病患者中3例阳性,而同时检查的60位健康者,他们的外周血CK-19均为阴性;不同年龄病人的CK-19检测阳性率对比,彼此之间差异无统计学意义;肿瘤不同分期CK-19阳性率对比差异有统计学意义。结论 RT-PCR法检测CK-19 mRNA可作为乳腺癌诊断的指标。 [关键词] 乳腺癌; CK-19 mRNA; 逆转录聚合酶链反应(RT-PCR) [中图分类号] R737.9 [文献标识码] A [文章编号] 1673-9701(2009)33-15-02 Clinical Significance of CK-19 mRNA in Patients with Breast Cancer MENG Fanjie WANG Yufang WANG Guofeng Yidu Central Hospital of Weifang City,Qingzhou 262500,China [Abstract] ObjectiveTo investigate the clinical significance of CK-19 mRNA in patients with breast cancer. MethodsThe CK-19 mRNA expression in the peripheral blood of 20 cases of breast cancer was measured by using RT-PCR method before operation,and 66 patients with benign breast diseases and 60 healthy women were taken as controls. ResultsThe positive rates of CK-19 mRNA in patients with breast cancer and benign breast diseases were 24%(48/200)and 4.54%(3/66),respectively,and CK-19 mRNA was all negative in the 60 healthy women. Thepositive rate difference between the breast cancer group and the control group was significant(P60岁的CK-19阳性率相似,他们之间并无统计学差异。因此,CK-19的阳性率与年龄无关。 乳腺肿瘤的大小是乳腺癌分期的一个重要的指标,也是决定乳腺癌预后的因素之一。根据世界卫生组织(WHO)1997年乳腺癌分期:导管内癌或湿疹样癌为Tis,肿瘤5cm为T3期,肿瘤侵犯皮肤或胸壁为T4期。本研究发现T1、T2期乳腺癌的CK-19阳性率无统计学意义,而T3的阳性率明显高于前两期,有统计学意义。由此说明随着肿瘤数目的增多及体积的增大,其血行转移的可能性就增加,特别是肿瘤大于5cm后,血行转移明显增加。同时也说明无论肿瘤有多大,都有可能出现血行播散(由于本研究中仅有4例导管内癌,尚无法证明Tis的肿瘤是否会存在血行播散的可能,这还有待更多的病例进行进一步的研究,从而也说明了为何仍有部分早期的乳腺癌病人会出现远处转移。 [参考文献] [1] Grunewald K,Haun M,Urbanek M,et al. Mammaglobin gene expression:a superior marker of breast cancer cells in peripheral blood in comparison to epidermal-growth-factor receptor and cytokeratin-19[J]. Lab Invest,2000,80(7):1071-1077. [2] Schoenfeld A,Kruger KH,CommJ,et al. The detection of micrometastasis in the peripheral blood and bone marrow of patients with breast cancer using immunohistochemi