乳腺癌患者CK19mRNA表达的意义及辅助化疗对骨髓微转移的影响  

The significance of CK19mRNA expression in patients with breast cancer and the effect of adjuvant chemotherapy on bone marrow micrometastasis

作　　者：张丽丽[1] 孙靖中[2] 顾禾[1] 时昌文[1] 曹莉莉[1] 

机构地区：[1]山东省千佛山医院普通外科,山东济南250014 [2]山东大学齐鲁医院乳腺外科,山东济南250014

出　　处：《中国普通外科杂志》2007年第1期47-50,共4页China Journal of General Surgery

摘　　要：目的探讨乳腺癌患者外周血、淋巴结和骨髓的微转移情况,以及辅助化疗对骨髓微转移的影响。方法采用RT-PCR技术同时检测可手术的69例乳腺癌患者的外周血、淋巴结和骨髓中CK19 mRNA的表达,并观察辅助化疗对骨髓微转移的影响。结果骨髓微转移24例(34.8%),外周血CK19mRNA阳性11例(15.9%)。淋巴结微转移阳性40例(58.0%),其中淋巴结病理学检查阳性的35例中,32例(91.4%)淋巴结微转移阳性,在淋巴结病理学检查阴性的34例中,8例(23.5%)淋巴结微转移阳性。淋巴结微转移阳性的40例中,18例(45.0%)骨髓微转移阳性。24例骨髓微转移阳性的患者在接受6个周期的CAF方案辅助化疗后,有7例骨髓微转移转阴(29.2%)。结论CK19 mRNA的表达可作为评价乳腺癌微转移的指标。外周血微转移的检测,其敏感性和特异性较骨髓差;骨髓微转移的检测可作为评价辅助化疗敏感性的指标之一。Objective To study the micrometastasis in peripheral blood, lymph node and bone marrow in patients with breast cancer and the effect of adjuvant chemotherapy on bone marrow micrometastasis. Methods RT-PCR technique was used to simultaneously detect the micrometastasis in peripheral blood, lymph node and bone marrow in 69 patients with operable breast cancer, and the effect of adjuvant chemotherapy on bone marrow micrometastasis was also investigated. Results The positivity of bone marrow micrometastasis tested by RT-PCR in breast cancer patients was 34. 8 %. The circulating tumor cells were found in 11 patients （15.9%）. Lymph node metastasis was positive in 35 cases, out of the 35 node-positive cases, 32 cases （ 91.4 % ） were lymph node micrometastasis, out of the 34 node-negative cases, eight cases （ 23.5 % ） were lymph node micrometastasis. Seven of 24 cases （ 29. 2% ） of bone marrow micrometastasis positive patients became negative after receiving six cycles of CAF adjuvant chemotherapy. Conclusions Detection of CK 19mRNA by RT-PCR is a sensitive and specific method of assessing micrometastasis in patients with breast cancer. Compared with the detection of bone marrow micrometastasis , the technique to detect the micrometastasis in peripheral blood is less sensitive or specific. The detection of bone marrow micrometastasis is a sensitive index to assess the effect of adjuvant chemotherapy.

关 键 词：乳腺肿瘤/病理学 肿瘤转移 骨髓 CK19MRNA 逆转录聚合酶链反应 预后 辅助化疗 

分 类 号：R737.9[医药卫生—肿瘤]