乳腺癌患者骨髓及外周血中微小转移标志物ck19mRNA的检测

【作者】 尉伟；

【导师】 梁军； 刘希光；

【作者基本信息】 青岛大学 ， 肿瘤内科， 2004， 硕士

【摘要】 目的:研究细胞角蛋白19(ck19)mRNA在乳腺癌患者骨髓与外周血中的表达以及与淋巴结转移的关系;并且为后期化疗方案有效性的监测做前期工作。Ck19mRNA主要表达于上皮来源的细胞,正常在造血及淋巴组织中不能检出,因而ck19mRNA是骨髓中上皮性癌细胞的特异标志物即研究中微小转移标志物。在乳腺癌患者骨髓和外周血中微转移灶的检出即ck19mRNA的检出对肿瘤的诊断、分期、复发和预后的判断、手术、综合治疗的选择,以及化疗的必要性和有效性的监测具有极其明显的指导意义。 方法:采用RT-PCR法,并以GAPDH为内对照,测定52例乳腺癌术后尚未行辅助化疗的患者(其中腋窝下淋巴结转移者30例,未发现淋巴结转移者22例)、健康女性查体者18例的骨髓及外周血中ck19mRNA的表达量。 结果:正常对照组骨髓及外周血中未见ck19mRNA的阳性表达,而52例乳腺癌患者骨髓ck19mRNA阳性38例(73.08%),外周血中ck19mRNA阳性7例(13.46%)。前者显著高于对照组,GAPDH在各组间的表达均无显著性差异(P>0.05)。其中30例淋巴结转移阳性的患者,骨髓ck19mRNA阳性28例,外周血ck19mRNA阳性5例。22例淋巴结转移阴性的患者骨髓ck19mRNA阳性10例,外周血ck19mRNA阳性2例。 结论:ck19mRNA在乳腺癌患者的骨髓中有明显表达(p<0.001);ck19mRNA作为微转移的一个有效指标其检出率与淋巴结转移阳性率存在差别(p<0.005),可作为一个独立的预后和风险因素存在,并认为其检出的临床意义优于淋巴结转移;RT-PCR技术是高度灵敏、高度特异的检测ck19基因的方法,可有效监测乳腺癌的诊断、治疗和预后。更多还原

【Abstract】 Purpose: The purpose of this study is to investigate the expression of Ckl9mRNA in the bone marrow and peripheral blood of the people with breast cancer and the relationship between Ckl9mRNA and the cancer and the relation between Ckl9mRNA and the lymph node metastasis and to provide guides for making preliminary effort to monitor the efficacy of the adjuvant chemotherapy. The main expression of Ckl9mRN A exists in the cells originating from the epithelium and usually can not be discovered in the hematogenic issues and lymphatic issues. So the discovery of Ckl9mRNA is the symbol of the existence of cancer cells in the epithelium, which is often regarded the existence of micrometastasis. The discovery of micrometastasis in the bone marrow and peripheral blood of the patients suffering from breast cancer, interms of, the presenting of Ck19mRNA, plays an important role in the diagnosis of the staging and the prognostic evaluation.lt may also help to determine whether an operation should be performed and how well the prognosis of the patients receiving the combined treatment should be. The test of the Ckl9mRNA in the bone marrow may provide a monitoring of the effectiveness and necessity of the chemotherapy.Methods: A method RT-PCR was adopted.compared with GAPDH. And the quantity of expression of Ckl9mRNA in the bone marrow and peripheral blood of 52 patients and 18 normal females.Results: No positive expression of Ckl9mRNA in the bone marrow and peripheral blood of the healthy females was found. Positive expression of Ckl9mRNA were found in bone marrow of 38 cases and in peripheral blood of 7 cases with breast cancer. In contrast, the expression of GAPDH had no difference among the groups(p>0.05). The positive expression rate of Ckl9mRNA in the bone marrow of 28 cases of the 30 patients with metastasis in the lymph node and the positive expression of Ckl9mRNA in更多还原