肺癌患者外周血CK19mRNA与微转移的实验研究

目的：检测非小细胞肺癌（NSCLC）患者外周血CK19mRNA的表达情况，探讨其诊断NSCLC外周血微转移的临床意义。方法：选取初治NSCLC患者40例及健康志愿者50例，用实时荧光定量RT—PCR方法检测外周血CK19mRNA，相对定量分析结果。结果：肺癌组与健康对照组CK19mRNA阳性表达率分别为72．5％（29／40）、14．0％（7／50），差异显著（P〈0．05）；相对表达量分别为1．69±0．44、0．28±0．12，有显著差异（P〈0．05）。阳性表达率与原发肿瘤部位、原发肿瘤大小、临床分期、分化程度及病理类型无相关性；相对表达量在中央型、T3＋T4、Ⅲ期＋Ⅳ期及低分化患者数值较高，但不具有统计学意义，鳞癌患者高于腺癌，且有显著差异（P〈0．05）。结论：CK19mRNA作为Real—time RT—PCR法检测NSCLC外周血微转移的分子标记物，具有一定临床应用价值，但特异性仍需提高，应进一步扩大样本进行研究及随访。相对定量分析是一种值得推荐、准确简便的荧光实时相对定量方法。

Real- time RT- PCR detection for CK19 mRNA in peripheral blood of non -small cell lung cancer patients

Objective ：To detect expression of CK19mRNA in peripheral blood of non - small - cell lung cancer （NSCLC） patients, discuss its clinical significance in diagnosis of micrometastases. Methods： Expression of CK19mRNA was detected in 50 patients with NSCLC and 40 healthy volunteers by real - time quantitative RT - PCR, the results were analyzed by relative quantitative method. Results：The expression rates of CK19mRNA in patients and the control group were 72.5% （ 29/40 ） and 14.0% （ 7/50 ） （ P 〈 0. 05 ） ; The relative level of expression of CK19mRNA in patients and the healthy volunteers were 1.69 ±0. 44 and 0.28 ± 0. 12 （ P 〈 0.05 ）. No significant correlation between the expression of CK19mRNA, tumor location, tumor size,TNM stage, cell differentiation and histology was found. The relative level in the patients with squamous cell carcinoma was higher than that in the patients with adenocarcinoma （P 〈 0.05 ） , no significant correlation between relative level of CK19mRNA, tumor location, tumor size, TNM stage and cell differentiation was found. Conclusion： Detection for CK19mRNA in peripheral blood of NSCLC patients may be useful for diagnosis of micrometastases, but the specificity must be improved. We need to have further studies with more samples and long - term follow - up. Relative quantitative method is accurate and conven- ient, it should be recommended.