【作者】 吴平平；

【导师】 黄培林；

【作者基本信息】 东南大学 ， 病理及病理生理， 2004， 硕士

【摘要】 【目的】通过联合检测hSTC-1、MAGE-3、CK20、CK19、CEA在上皮性恶性肿瘤患者外周血循环有核细胞中表达,结合临床病理资料综合分析,探讨靶基因的表达及其临床病理学意义。【方法】应用RT-PCR技术联合检测93例上皮性恶性肿瘤患者外周血单个核细胞hSTC-1、MAGE-3、CK20、CK19、CEA表达情况;另取16例上皮性恶性肿瘤组织为阳性对照,18例非肿瘤患者外周血为阴性对照。将检测结果与患者的临床病理资料综合分析。【结果】受检的上皮性恶性肿瘤患者外周血中hSTC-1阳性表达率50.5%(47/93);MAGE-3阳性表达率27.9%(26/93);CK20阳性表达率45.1%(42/93);CK19阳性表达率35.4%(33/93); CEA阳性表达率44.0%(41/93)。结合临床病理资料综合分析患者外周血中hSTC-1、MAGE-3、CK20、CK19、CEA阳性表达与年龄及性别均无关,CK19阳性表达与肿瘤浸润深度、临床分期及有无淋巴结转移、远处转移呈显著相关(P<0.05);CEA、hSTC-1阳性表达与肿瘤临床分期、有无淋巴结转移、远处转移呈显著相关(P<0.05);而CK20、MAGE-3的阳性表达与肿瘤患者病理资料之间无明显相关性。多基因检测时,联合检测hSTC-1、MAGE-3、CK20、CK19、CEAmRNA可增加外周血肿瘤细胞的检出率,两基因的CK19/ hSTC-1、CK19/ CEA或hSTC-1/MAGE-3;三基因的CK19/ CEA/ hSTC-1、CK19/ hSTC-1/ MAGE-3或CK19/ CEA/MAGE-3;四基因的CK20/CK19/hSTC-1/MAGE-3、CK20/CK19/CEA/MAGE-3或CK19/CEA/hSTC-1/MAGE-3检测意义最显著,其与肿瘤的浸润深度、临床分期、淋巴结转移、远处转移均呈显著相关。两个或两个以上基因同时表达时特异性强,两基因的CK20+CK19;三基因的CK20+CK19+hSTC-1、CK20+CEA+MAGE-3或CK19+CEA+MAGE-3;四基因CK20+CK19+CEA +MAGE-3检测意义最好,其与肿瘤的浸润深度、临床分期、淋巴结转移、远处转移均呈显著相关。16例恶性肿瘤组织中CK20、CK19、CEA、hSTC-1全部表达;13例MAGE-3表达阳性。18例非肿瘤患者外周血CEA、CK19各2例表达;1例 CK20表达;hSTC-1、MAGE-3无1例表达 。【结论】hSTC-1、MAGE-3、CK20 、CK19、CEA mRNA可作为检测上皮性恶性肿瘤外周血微转移的靶基因。联合检测肿瘤患者外周血hSTC-1、MAGE-3、CK20 、CK19、CEA mRNA可提高外周血循环肿瘤细胞的检测率。两个或以上基因同时表达特异性强。将实验结果与肿瘤患者临床病理资料综合分析可发现外周血中的靶基因不同组合的表达与肿瘤的浸润深度、临床病理分期、淋巴结转移、远处转移呈现相关性的情况,这有助于判断肿瘤的恶性生物学行为、指导临床治疗和评估预后。更多还原

【Abstract】 [Objective] To study the expression of hSTC-1 , MAGE-3 , CK20, CK19, CEA in the peripheral blood from the patients of epithelial malignancies using RT-PCR technique, and to deduce its clinical significance. To study the relationship between the expression of mRNA in the peripheral blood from patients with epithelial malignancies and clinical pathology.[Methods] A total of 93 preoperative peripheral blood specimens obtained from patients with epithelial malignancies were studied by hSTC-1, MAGE-3 , CK20, CK19 and CEA specific RT-PCR assay. As control, 16 fresh tumor tissues and blood samples from 18 patients without cancer were also analyzed . [Results] The positivity for hSTC-1, MAGE-3, CK20, CK19, CEA mRNA expression was 50.5%(47/93), 27.9%(26/93), 45.1%(42/93), 35.4%(33/93)and 44.0%(41/93)respectively, in the peripheral blood from patients with epithelial cancers. 50.5% ~ 86.0% was positive for at least one markers. In primary tumors, 16 tumor tissues were all positive for CK20, CK19, CEA, hSTC-1 mRNA , and 13 tumor tissues were all positive for MAGE-3 . In 18 blood samples from nomalignant control subjects, two were positive for CK19 and CEA respectively, and one was positive for CK20, and none for positive for hSTC-1 and MAGE-3.[Conclusion] These data indicated that the hSTC-1, MAGE-3 , CK20, CK19, CEA mRNA expression may be potential biomarkers for detectintg micrometastasis and recurrence in the peripheral blood with epithelial cancers. It was potentially very useful to use multi-markers in detecting the circulating tumor cells, and a multiple marker PCR assay may help increase PCR positivity. when we analysed the experiment result linked with clinical pathology of tumour patients, we analysed the relation of mRNA expressions of hSTC-1, MAGE-3, CK20, CK19, CEA in the peripheral blood with the infiltration depth、clinical pathological stages、 lymph metastasis and distant metastasis of carcinoma.更多还原