喉、喉咽癌患者外周血播散肿瘤细胞检测的初步研究  

Detection of disseminated tumor cells in the peripheral blood of patients with laryngeal or laryngopharyngeal carcinomas

作　　者：李平栋[1] 于振坤[1] 黄志刚[1] 房居高[1] 倪鑫[1] 王琪[1] 范尔钟[2] 李颖[2] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730 [2]北京市耳鼻咽喉科研究所,北京100005

出　　处：《中国耳鼻咽喉头颈外科》2006年第4期215-218,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：北京市科技新星课题资助项目(953812500)

摘　　要：目的探讨RT-PCR以CK19mRNA作为标记物在检测喉癌、喉咽癌患者外周血播散肿瘤细胞(disseminatedtumorcell,DTC)的意义。方法采用套式RT-PCR,以CK19mRNA为指标,检测32例喉癌、喉咽癌患者外周血中的DTC。结果CK19mRNA总阳性率为46.9%(15/32);其中喉癌阳性率为40%(10/25);喉咽癌阳性率为71.4%(5/7)。20例正常对照组全部阴性。淋巴结转移组阳性率75%(9/12),非淋巴结转移组阳性率30%(6/20),两者之间有显著性差异(P<0.05)。阳性组患者的无瘤生存期(20.29±5.16月)比阴性组(37.13±3.23月)明显缩短,经Log-rank检验有统计学差异(P=0.046,<0.05),阳性组的复发率(66.7%)比阴性组(18.8%)增高(P<0.05)。并且做了生存分析,有统计学差异(P=0.015,<0.05)。结论以CK19mRNA肿瘤标记物,用精确设计的RT-PCR技术对外周血DTC的检测有助于喉癌、喉咽癌转移的早期发现;随访初步发现用DTC的检测有望作为肿瘤复发和远处转移的早期预示手段。OBJECTIVE To investigate the diagnostic and prognostic value of molecular biological detection of DTC in peripheral blood. METHODS 32 cases of laryngeal or laryngopharyngeal carcinoma were investigated. DTC in peripheral blood was detected by nested reverse transcription polymerase chain reaction, using CK19mRNA as the marker. RESULTS In the RT-PCR study, 15 of 32 cases （46.9 %） showed a positive result. Ten of the 25 cases （40 %） of laryngeal carcinoma were positive. Fix of the remaining 7 cases （71.4 %） of laryngopharyngeal carcinoma were positive. All controls were negative. Of the 20 cases without lymph node metastasis, 6 were positive; of the 12 cases with lymph node metastasis, 9 were positive. The positive rate of the group with lymph node metastasis was higher than that of the group without lymph node involvement（P〈0.05）. Grouping according to the RT-PCR result showed that the disease-free survival time of the positive group（20.29 ±5.16 months） was significantly shorter than that of the negative group（37.13±3.23 months, P〈0.05, with Log-rank test）, and that the recurrence rate of positive group （66.7 %） was higher than that of the negative group （18.8 %, P〈0.05）. Kaplan- Meirer survival analysis of 28 cases showed that the survival rate of positive group was declining （P〈0.01, with Logrank test）. CONCLUSION This study indicated that CK19mRNA is a potential marker for laryngeal and laryngopharyngeal carcinoma. DTC detection in peripheral blood by our meticulously designed RT-PCR system may be able to find the early metastasis event. According to our follow-up result, it may also indicate the carcinoma recurrence and distant metastasis rate.

关 键 词：喉肿瘤 下咽肿瘤 肿瘤转移 肿瘤循环细胞 逆转录聚合酶链反应 

分 类 号：R739.6[医药卫生—肿瘤]