乳腺癌患者术后腋窝引流液中细胞角蛋白19mRNA的水平及临床意义  

Clinal significance of cvtokeratin-19 mRNA in postoperative axillary drainage in breast cancer patients

作　　者：黄建康[1] 董慧明[1] 宋文华[1] 王万霞[1] 朱正志[1] 马小开[1] 

机构地区：[1]蚌埠医学院第一附属医院肿瘤外科,233004

出　　处：《中国医药》2015年第10期1493-1495,共3页China Medicine

基　　金：安徽省高校青年教师科研资助计划（2006jq1182）

摘　　要：目的 探究乳腺癌患者术后腋窝引流液中细胞角蛋白（CK）19 mRNA的水平及临床意义.方法 选取2012年1月至2014年1月蚌埠医学院第一附属医院收治的90例女性乳腺癌患者（乳腺癌组）,所有患者均行乳腺癌改良根治术,同时选取50例女性乳腺良性病变的患者作为对照组,采集2组患者术后第2天腋窝引流液,提取引流液mRNA,采用实时聚合酶链反应检测并比较2组患者CK-19 mRNA水平,分析不同乳腺癌病理分期、淋巴结转移、肿瘤大小与CK-19 mRNA阳性的关系.结果 乳腺癌组患者CK-19 mRNA水平明显高于对照组,差异有统计学意义[（7.6±3.5）比（1.0±0.5）,P＜0.05].乳腺癌组患者32例CK-19 mRNA阳性,阳性率明显高于对照组[35.6％ （32/90）比0.0％ （0/50）],差异有统计学意义（P＜0.05）.乳腺癌患者随着病理分期的加重,CK-19 mRNA阳性率升高,Ⅰ、Ⅱ、Ⅲ期分别为19.4％（7/36）、35.5％（11/31）、60.9％（14/23）,两两比较差异均有统计学意义（P＜0.05）.腋窝淋巴结转移阳性患者CK-19 mRNA阳性率明显高于腋窝淋巴结转移阴性患者,差异有统计学意义[52.2％（24/46）比18.2％ （8/44）,P＜0.05].随着乳腺癌患者肿瘤病灶的增大,CK-19 mRNA阳性率逐渐升高,肿瘤直径≤2 cm、＞2 cm且≤5 cm、＞5 cm CK-19 mRNA阳性率分别为15.4％（2/13）、28.8％（15/52）、60.0％（15/25）,两两比较差异均有统计学意义（P＜0.05）.结论 乳腺癌患者术后腋窝引流液CK-19 mRNA水平明显升高,且与病理分期、肿瘤大小、淋巴结转移有相关性;CK-19 mRNA在腋窝引流液中的水平可以作为评判预后的重要指标.Objective To explore the clinical significance of cytokeratin-19 mRNA in postoperative axillary drainage in breast cancer patients.Methods Totally 90 female patients with breast cancer who underwent modified radical mastectomy from January 2012 to January 2014 were enrolled （breast cancer group）;50 patients with benign breast lesions were set as a control group.The axillary drainage 2 days after operation was collected and real time-polymerase chain reaction was used to detect the level of CK-19 mRNA in the drainage.The level of CK-19 mRNA was compared between the two groups and the correlations of CK-19 mRNA level with pathology stage,lymph node metastasis and tumor size were analyzed.Results The level of CK-19 mRNA in breast cancer patients was significantly higher than that in control group [（7.6 ± 3.5） vs （1.0 ± 0.5）] （P 〈 0.05）;the positive rate of CK-19 mRNA in breast cancer group was significantly higher than that in control group [35.6% （32/90） vs 0.0% （0/50）] （P 〈 0.05）.The positive rate of CK-1 9 mRNA was increased along with pathological stage [stage Ⅰ ∶ 19.4% （7/36）,stage Ⅱ ∶ 60.9% （14/23）,stage Ⅲ ∶ 60.9% （14/23）] （P 〈 0.05）;the positive rate of CK-19 mRNA in patients with axillary lymph node metastasis was significantly higher than that in patients without axillary lymph node metastasis [52.2% （24/46） vs 18.2% （8/44）] （P 〈0.05）;the positive rate of CK-19 mRNA was increased with increase of the tumor size [diameter ≤2 cm：15.4% （2/13）,2 cm 〈 diameter ≤5 cm：28.8% （15/52）,diameter 〉5 cm：60.0% （15/25）] （P〈0.05）.Conclusion The level of CK-19 mRNA in postoperative axillary drainage in breast cancer patients is increased and related to pathologic stage,tumor size and axillary lymph node metastasis;the level of CK-19 mRNA can be used as a indicator to assess the prognosis.

关 键 词：乳腺癌 腋窝引流液 细胞角蛋白19 信使核糖核酸 

分 类 号：R737.9[医药卫生—肿瘤]