早期乳腺癌患者外周血CK19 mRNA阳性循环细胞检测及其临床意义  

Detection and significance of CK19 mRNA-positive circulating tumor cells in peripheral blood of patients with early breast cancer

作　　者：陈艳[1] 邹天宁[2] 王熙才[1] 伍治平[1] 金从国[1] 谷玉兰[1] 周永春[1] 刘馨[1] 

机构地区：[1]云南省肿瘤医院云南省昆明医学院第三附属医院肿瘤研究所,昆明650118 [2]云南省肿瘤医院云南省昆明医学院第三附属医院乳腺科,昆明650118

出　　处：《肿瘤研究与临床》2010年第3期164-167,共4页Cancer Research and Clinic

基　　金：云南省教育厅基金（04Y029C）、云南省应用基础研究基金（2007C0024R,2009CD181）

摘　　要：目的探讨早期乳腺癌患者外周血CK19mRNA阳性细胞检测的临床意义及其预后价值。方法应用RT—PCR检测50例早期乳腺癌患者、24例良性乳腺病变患者及20名健康体检志愿者外周血有核细胞CK19mRNA的表达，并根据基因标志物结果随访。结果早期乳腺癌患者术后辅助治疗前外周血有核细胞CK19mRNA阳性率40．0％（20／50），与良性乳腺疾病患者[12．5％（3／24）1及健康体检志愿者[5％（1／20）]比较，差异均有统计学意义（P=0．018，P=0．004）；外周血有核细胞CK19-mRNA阳性率与患者年龄、月经状况、TNM分期、肿瘤大小、淋巴结转移状况、病理分化、激素受体状况、Her-2、血清CA153、血清CEA水平异常升高无关（P〉0．05）；20例外周血有核细胞CK19mRNA阳性的患者中有11例随访期出现转移复发（P=0．002），中位无瘤生存期明显缩短（P=0．007）。结论CK19mRNA可以作为循环肿瘤细胞基因标志物。检测CK19mRNA阳性循环肿瘤细胞，可能作为早期乳腺癌术后判断复发转移的辅助指标。Objective To study the clinical and prognostic value of CK19 mRNA-positive circulating tumor cells in early breast cancer patients. Methods We analyzed the peripheral blood in 50 patients with early breast cancer after surgery and before the initiation of any adjuvant treatment for the presence of CK19 mRNA-positive circulating tumor cells using a nest reverse polymerase chain reaction assay. All patients were followed up. Results CK19 mRNA-positive cells were detected in 40.0 %（20/50） of patients with early breast cancer, 12.5 %（3/24） of patients with breast benign lesions, but 5 %（1/20） in healthy individuals （P =0.017, P =0.004）; 11 to 20 of them relapsed during the follow-up period （P =0.002）. There was no significant association between the detection of CK19 mRNA-positive cell and the patients＂ menstrual status, tumor stage, tumor size, etc （P 〉0.05）. Detection of peripheral-blood CK19 mRNA-positive cells was associated with reduced median relapse-free interval in early breast cancer patients （P =0.007）. ConclusiOn CK19 mRNA is one of the molecular markers for the detection of circulating tumor cells in early breast cancer. Detection of peripheral blood CK19 mRNA-positive cells might be an important predictive value as a marker of relapse in early breast cancer patients.

关 键 词：乳腺肿瘤 肿瘤循环细胞 微转移 CK19 MRNA 

分 类 号：R737.9[医药卫生—肿瘤]