肺癌患者三种微转移标志物临床意义的比较研究  

Clinical significance of LUNX mRNA, CK19 mRNA, CEA mRNA expression in detecting micrometastasis from lung cancer

作　　者：朱广迎[1] 刘德林[2] 陈杰[2] 

机构地区：[1]北京大学临床肿瘤学院放射治疗科,100036 [2]江苏省徐州医学院肿瘤研究所放射治疗科,221002

出　　处：《中华放射肿瘤学杂志》2003年第3期178-182,共5页Chinese Journal of Radiation Oncology

摘　　要：目的 评价肺癌患者外周血LUNX mRNA、CK19 mRNA、CEA mRNA诊断微转移的特异性、敏感性,探索肺癌患者微转移的早期诊断。方法 以肺部良性疾病30例、健康人10例的外周血为对照,以LUNX mRNA、CK19 mRNA、CEA mRNA的表达为指标,采用逆转录聚合酶链反应(RT-PCR)检测48例肺癌患者外周血、手术切除区域44个淋巴结的微转移,并根据淋巴结病理切片、临床分期、随访过程中复发转移率评价微转移的临床意义。结果 ①LUNX mRNA、CK19 mRNA、CEA mRNA在肺癌组织的表达率均为100％(35/35)。②48例肺癌患者外周血中LUNX mRNA阳性30例(62.5％),CK19 mRNA阳性24例(50.0％),CEA mRNA阳性32例(66.7％);44枚肺癌患者手术切除的区域淋巴结,LUNX mRNA阳性16枚(36.4％),CK19 mRNA阳性12枚(27.3％),CEA mRNA阳性18枚(40.9％)。③30例肺部良性疾病患者外周血中,CK19 mRNA表达阳性2例(6.7％),LUNX mRNA或CEA mRNA表达均阴性;10例健康人外周血和11枚取自肺良性疾病患者的淋巴结,3个指标检测结果均为阴性。④44枚肺癌区域淋巴结中,普通病理组织学检出6枚(13.6％)有癌转移,阳性率明显低于RT-PCR检测结果(P<0.05)。⑤3种微转移指标的阳性率均随TNM分期的增加而升高(P=0.01)。⑥随访发现外周血微转移阳性患者的复发率高于阴性患者。结论Objective To evaluate the sensitivity, specificity and clinical significance of CK19 mRNA, CEA mRNA and LUNX mRNA for detecting micrometastasis by sampling the peripheral blood and regional lymph nodes of lung cancer patients. Methods Reverse transcriptase polymerase chain reaction (RT-PCR) was used to detect LUNX mRNA,CK19 mRNA, CEA mRNA for micrometastasis by sampling the peripheral blood of 48 lung cancer patients and 44 regional lymph nodes of such patients treated by curative resection. Peripheral blood of 30 patients with pulmonary benign lesions and 10 normal healthy volunteers and lymph nodes of 6 patients with benign pulmonary diseases served as control. Results (1) LUNX mRNA, CK19 mRNA, CEA mRNA were expressed in all(35/35) lung cancer tissues. (2) In the peripheral blood from 48 lung cancer patients, 30(62.5%) were positive for LUNX mRNA, 24 (50.0% ) positive for CK19 mRNA and 32(66.7%) positive for CEA mRNA. The positive detection rates of micrometastasis in 44 lymph nodes from lung cancer patients were 36.4% (16 out of 44) for LUNX mRNA, 27.3%(12 out of 44) for CK19 mRNA and 40.9%(18 out of 44) for CEA mRNA. (3) In the 30 blood samples from patients with pulmonary benign diseases, 2 (6.7%) expressed CK19 mRNA, but none expressed LUNX mRNA or CEA mRNA. All the 3 molecular markers were negative in the 10 blood samples from healthy volunteers. In 11 lymph nodes from patients with pulmonary benign lesions, none was positive for any of the three markers.(4)In 44 regional lymph nodes from lung cancer patients,6(13.6%) were positive for metastasis by histopathological examination, with a positive rate significantly lower than that of the RT-PCR ( P < 0.05 ) . (5) The micrometastatic positive rate in the peripheral blood of 40 non-small cell lung cancer (NSCLC) patients was significantly related to TNM stage (P = 0.01). Conclusions LUNX mRNA, CK19 MRNA, CEA mRNA are all appropriate target genes for the detection of micrometastasis from lung cancer. LUNX mRNA and CEA mRNA are more specific than CK19 mRNA in d

关 键 词：肺癌 肿瘤微转移 转移标志物 肿瘤循环细胞 淋巴转移 CKL9 CEA 外周血 LUNX 

分 类 号：R734.2[医药卫生—肿瘤]