摘要
目的探讨细胞角蛋白19（CK19）mRNA、癌胚抗原（CEA）mRNA的表达在诊断乳腺癌患者外周血微转移的临床意义及与临床病理指标的关系。方法采用实时定量聚合酶链反应（RQ—PCR）法，测定28名健康女性志愿者、20例良性乳腺疾病患者、108例乳腺癌患者（88例行手术切除乳腺癌患者、20例复发转移乳腺癌患者）的外周血中CK19、CEAmRNA的表达。以上有一项为阳性即判定为转移。结果28名健康对照者CK19mRNA和CEAmRNA两个指标检测结果均为阴性。20例良性乳腺疾病患者中，CK19mRNA阳性1例（5％），无CEAmRNA表达阳性者。108例乳腺癌患者中，26例（24，1％）CK19mRNA阳性，23例（21．3％）CEAmRNA阳性，15例（13，9％）两者均阳性。在108例乳腺癌患者中，复发转移乳腺癌患者CK19mRNA和（或）CEAmRNA的表达高于行手术切除乳腺癌患者。88例行手术切除乳腺癌患者外周血微转移阴性组、阳性组在肿瘤大小、病理分期、ki67，细胞黏附分子CD44变异型、，6（CDd4v6），血管内皮生长因子（VEGF）表达方面差异有统计学意义（P〈0．05），但在年龄、肿瘤位置、病理组织学类型、淋巴结转移、雌激素受体（ER）、孕激素受体（PR）、CerbB2、基质金属蛋白酶9（MMP9）表达等方面差异无统计学意义（P〉0．05）。多因素分析表明肿瘤大小、病理分期、ki67、CD44v6、VEGF与患者外周血微转移有关。结论联合检测CK19mRNA和CEAmRNA可提高乳腺癌患者外周血微转移的检出率。肿瘤大小、病理分期、ki67、CDd4v6、VEGF可评估乳腺癌患者外周血微转移风险。
Objective To explore the clinical significance of detection of cytokeratin 19 （CK19） mRNA and carcinoembryonic antigen （CEA） mRNA expression in the diagnosis of micrometastasis in the peripheral blood of patients with breast cancer, and the relationship with other clinicopathological characteristics. Methods Peripheral blood samples were collected from 28 normal female healthy volunteers, 20 patients with benign breast disease, and 108 patients with breast cancer （88 had undergone operation and 20 with metastasis）. Real-time quantitative PCR was used to detect the mRNA expression of CKI9 and CEA in the peripheral blood. Results mRNA expression was negative in the blood samples from the 28 normal volunteers for both CK19 and CEA. None of the 20 patients with benign breast disease was positive for CEA mRNA, but one was positive for CK19 mRNA （5%）. Of the 108 patients with breast cancer, 26 （24.1%） were positive for CK19 mRNA, 23 （21.3%） were positive for CEA mRNA, and 15 （ 13.9% ） were positive for both CK19 mRNA and CEA mRNA. The positive rates of CK19 mRNA and/or CEA mRNA of the metastatic breast cancer patients were higher than those of the operable breast cancer patients. Statistically significant differences in tumor size, clinical stage, and expression levels of k167, variant exon 6 containing isoforms of CD44 （CD44v6） , and vascular endothelial growth factor（VEGF） were found between the operable breast cancer patients with micrometastasis in peripheral blood and the patients without micrometastasis （all P 〈 0.05）. And there was no statistically significant difference between the two groups in age, tumor location, pathological histological type, nodal metastasis, and expression levels of estrogen receptor （ER） , pregnant receptor（PR） , CerbB2, and matrix metalloproteinase-9 （ MMP9 ） （ all P 〉 0.05 ）. Multivariate analysis showed that tumor size, clinical stage, expressions of ki67, CD44v6, and VEGF were associated with micrometastasis in peripheral b
出处
《中华医学杂志》
CAS
CSCD
北大核心
2008年第32期2267-2270,共4页
National Medical Journal of China
关键词
乳腺肿瘤
癌胚抗原
角蛋白
循环肿瘤细胞
诊断
Breast neoplasms
Carcinoembryonic antigen
Keratin
cells
Diagnosis and VEGF are effective Neoplasm circulating
