CK20、CK19、CEA在肺癌患者外周血中的表达及其意义  

Clinical Signif icance of CK20,CK19,CEA mRNAs in Peripheral Blood from Lung Cancer Patients

作　　者：郭英[1] 王景美[2] 黄培林[3] 

机构地区：[1]南京中医药大学病理系,南京210029 [2]南京大学医学院附属鼓楼医院病理科,南京210008 [3]东南大学临床医学院,南京210009

出　　处：《中国肺癌杂志》2009年第9期1013-1017,共5页Chinese Journal of Lung Cancer

基　　金：江苏省卫生厅重点资助项目基金(No.H200116)资助~~

摘　　要：背景与目的恶性肿瘤在其早期阶段即可能发生微转移,由于进入血液循环中的肿瘤细胞数目极少,常规的检测手段不易发现,现代分子生物学技术进展使微转移检测成为可能。本研究联合检测肺癌患者的外周血CK20、CK19、CEA mRNA表达,并分析其临床意义。方法应用巢式RT-PCR法分析83例肺癌患者外周血单个核细胞CK20、CK19、CEA mRNA表达情况;另取15例食管癌组织为阳性对照,15例非肿瘤患者外周血为阴性对照。结果83例肺癌患者外周血中,CK20阳性表达率为34/83(41.0%),CK19阳性表达率为30/83(36.1%),CEA阳性表达率为40/83(48.2%);三者至少一项阳性的表达率为61/83(73.5%)。15例食管癌组织中CK20、CK19、CEA阳性表达率100%,15例阴性对照组外周血CK19、CEA阳性表达率均为2/15(13.3%);CK20阳性表达率为1/15(6.67%)。CK20、CK19、CEA mRNA阳性表达与肿瘤有无转移有关(P<0.05),与肿瘤患者的年龄、性别无关。结论CK20、CK19、CEA mRNA可作为检测肺癌患者外周血微转移的靶基因,联合检测CK20、CK19、CEA可增加外周血循环癌细胞的检出率,CK20、CK19、CEA mRNA同时表达可增加实验结果特异性。Background and objective The tumor cells may disseminate into circulation even in early stages. However, the numbers of such cells are so small that they cannot be detected by conventional diagnostic methods. Developments in molecular technology have made it possible to detect small numbers of tumor cells in peripheral blood. In this study, 83 preoperative peripheral blood samples from patients with lung cancer were analyzed for the determination of CEA, CK19, and CK20 mRNA expression in peripheral blood, and its clinical significance was evaluated. Methods Nested reverse transcriptase- polymerase chain reaction （nested RT-PCR） was used to analyze CEA, CK19, and CK20 mRNA expression in peripheral blood. Fresh tumor tissues from patients with esophageal cancer （n=15） were used as a positive control, and blood samples from 15 healthy volunteers as a negative control. Results Among 83 blood samples from patients with lung cancer, the expression of CK20, CK19 and CEA mRNA was 41.0%, 36.1% and 48.2%, respectively. 73.5% were positive for at least one markers for these three genes, and were significantly correlated with the metastasis of the cancer （P〈0.05）, but had no correlation with age and sex. In primary esophageal tumors, 15 tumor tissues were all positive for CEA, CK19, and CK20 mRNA. 2 of 15 blood samples from healthy donors were positive for CK19 and CEA mRNA, and 1 of 15 blood sample positive for CK20 mRNA. Conclusion The three markers of CK20, CK19 and CEA mRNA could be the target genes in detecting circulating tumor cells in peripheral blood from patients with lung cancer. The combined detection of CK20, CK19 and CEA mRNA by RT-PCR assay may contribute to the PCR positivity and sensitivity, and CK20, CK19, CEA mRNA expression increase the specificity.

关 键 词：肺肿瘤 逆转录-聚合酶链式反应 角蛋白 癌胚抗原 

分 类 号：R734.2[医药卫生—肿瘤]