乳腺癌腋窝淋巴结微转移CK19 mRNA基因检测的临床意义  

The clinical significance of CK19 mRNA for detection of axillary lymph node micrometastasis in breast cancer

作　　者：姚宏[1] 郭江泽[2] 魏正俐[3] 王虹[1] 平苏萍[1] 张庆升[1] 郭秀丽[1] 

机构地区：[1]太原市人民医院病理科,030001 [2]太原市人民医院胸科,030001 [3]太原市人民医院内科,030001

出　　处：《中国药物与临床》2008年第5期365-367,共3页Chinese Remedies & Clinics

基　　金：太原市科技基金资助项目(0503058)

摘　　要：目的运用反转录聚合酶链反应(RT-PCR)的方法检测乳腺癌腋窝淋巴结微转移。方法对15例乳腺癌患者的122个腋窝淋巴结和5个正常对照淋巴结同时进行苏木素-伊红(HE)染色组织学检查和细胞角蛋白19(CK19)RT-PCR检测。结果15例乳腺癌组织均有CK19 mRNA表达,而5个正常淋巴结中均未见表达。122个腋窝淋巴结中14个组织学检查证实转移,其CK19 mRNA亦表达阳性。组织学检测无转移的108个淋巴结中有24个CK19 RT-PCR表达阳性,84个阴性;提示该24个淋巴结存在微转移只能用CK19 RT-PCR方法检测出。经统计学分析,CK19 RT-PCR与组织学检查二者差异有统计学意义(P<0.01)。结论CK19表达于恶性乳腺细胞,正常淋巴细胞无表达,CK19能作为组织特异基因进行RT-PCR扩增以检测乳腺癌腋窝淋巴结微转移。CK19 RT-PCR方法比组织学方法更敏感,特别对在筛选组织学检查淋巴结阴性而具有高度复发危险性的患者将有实用价值。Objective To develop a sensitive method for detection of axillary lymph node （LN） micrometastasis in breast cancer. Methods One hundred and twenty-two axillary LNs from 15 patients with breast carcinoma and 5 control LNs were subjected to pathological examination using HE staining as well as reverse transcriptase polymerase chain reaction （RT-PCR）. Results CK19 mRNA expression was detected in all 15 primary breast cancers but not in 5 control LNs. Of 122 axillary LNs, 14 LNs were found to have metastasis by HE staining and CK19 RT-PCR. Of the remaining 108 LNs considered to be metastasis-negative by HE staining, 24 were found to have metastases by CK19 RT-PCR and 84 were negative by the both studies, suggesting that the CK19 RT-PCR alone identified the 24 lymph nodes which were not detectable with conventional histopathological method. There was a significant difference in the results between RT-PCR and HE staining （chi square test, P〈0.01）. Conclusion CK19 is expressed in malignant breast ceils but not in normal lymphocytes. CK19 mRNA can be targeted as a tissue specific marker for micrometastasis detection in breast cancer. Detection of CK19 mRNA appears more sensitive than histologic study to reveal LN involvement of breast cancer, especially in those who screened negative by conventional pathology but were at a higher risk of tumor recurrence.

关 键 词：乳腺肿瘤 腋窝淋巴结 CK19 逆转录聚合酶链反应 

分 类 号：R737.9[医药卫生—肿瘤]