摘要
背景与目的：采用RT—PCR技术检测CK19（cytokeratin 19）mRNA的转录，可在部分恶性肿瘤患者中检测到常规病理学方法不能检测到的隐性微转移。本研究旨在检测宫颈癌患者盆腔淋巴结组织特异性标志物（CK19mRNA）的表达，并探讨其临床意义。方法：采用RT—PCR技术检测Ⅰ～Ⅱ期宫颈癌患者盆腔淋巴结CK19 mRNA的转录。生存曲线用Kaplan—Meier转录。生存率比较采用Log—rank检验。结果：32例宫颈癌患者共检测淋巴结标本206枚，经常规病理组织学方法检测到24枚淋巴结有癌转移，阳性率为12％（24／206）；经RT—PCR法检测到44枚淋巴结表达CK19 mRNA，检出率为21％（44／206）。RT—PCR法与常规病理组织学方法比较，差异有显著性（P〈0．01）。常规HE染色阴性的182枚淋巴结中，29枚检测到CK19mRNA的特异性条带，微转移的检出率为15．9％（29／182）。低分化患者的淋巴结CK19检出率为87．5％（7／8）显著高于中～高分化患者的检出率33．3％（8／24）（P〈0．05）。而淋巴结CK19的检出率与年龄、临床分期、组织学类型、宫颈肿瘤大小、肌层浸润深度、宫旁浸润、脉管癌栓均无明显关系（P〉0．05）。淋巴结CK19 mRNA阳性患者的4年无瘤生存率为58％；而淋巴结CK19 mRNA阴性患者的4年无瘤生存率为76．5％，差异无显著性（P〉0．05）。结论：与传统的病理组织学比较，采用RT—PCR技术检测CK19 mRNA转录能显著提高淋巴结微转移的检出率，预后判断有待增大病例数进一步研究。
Background and purpose： Expression of CK19 mRNA detected by Reverse transcription polymerase chain reaction （ RT-PCR）, which can not be detected by routine pathological method, can predict micrometastases in patients with malignant tumors. The objective of this study was to investigate the expression of CK19 mRNA in pelvic lymph nodes of the patients with cervical cancer and its clinical significance. Methods： RT-PCR was utilized to detect the expression of CK19 mRNA in the 206 pelvic lymph nodes of 32 patients with clinical stage Ⅰ - Ⅱ cervical cancer. Survival rates were calculated by Kaplan-Meier method with difference in survival estimated by Log-rank test. Results： Histopathologic examinations demonstrated the presence of metastases in 24（11.7%） lymph nodes. However, RT-PCR detected the expression of CK19 in 44（21.4%） lymph nodes （ P 〈0.01）. Expression of CK19 was detected by RT-PCR in 29 （15.9%） of 182 histologically uninvolved lymph nodes that were negative by HE staining, these samples were confirmed to have micrometastasis. The CK19 positive rate was 87.5% （7/8） in the patients with poor differentiation grade, which was higher than 33.3%（8/24） in the cases with grades being moderately to well differentiated （P 〈0.05）. However, the expression of CK19 was not associated with other characteristics such as age, clinical stage, histopathological type, tumor size, deep stromal invasion, parametrial extension or lymphvascular invasion （P 〉 0.05）. The 4-year disease-free survival of the patients with lymph node CK19 positive was 58.2%, which was not significantly different from 76.5% for the patients with CK19 negative （P 〉0.05）. Conclusions： CK19 mRNA may be considered as a powerful biomarker in the detection of micrometastases in the lymph nodes of patients with cervical cancer in terms of the sensitivity. Further study is needed to clarify its role in predicting prognosis of the patients.
出处
《中国癌症杂志》
CAS
CSCD
2006年第11期926-930,共5页
China Oncology
