CK-19mRNA表达与乳腺癌关系的研究

目的：探讨乳腺癌患者外周血中细胞角蛋白19mRNA（CK-19mRNA）的表达与手术、化疗、临床病理的关系及其临床意义。方法：应用实时荧光定量PCR检测60例Ⅱ、Ⅲ期乳腺癌患者手术及化疗前后外周静脉血CK-19mRNA的含量。选择20例乳腺良性疾病手术患者做为对照。结果：对照组外周血中未检出CK-19mRNA。术前乳腺癌组外周血CK-19mRNA阳性率为30．0％（18／60），与对照组比较有显著差异（P〈0．05）。术后1周内及术后化疗1周期后CK-19mRNA阳性率分别降至25．0％（15／60）和13．3％（8／60）。Ⅲ期乳腺癌CK-19mRNA的阳性表达率高于Ⅱ期（P〈0．05），CK-19mRNA的表达与激素受体、HER2表达无关（P〉0．05）。有神经及脉管受侵或淋巴结转移者CK-19mRNA的阳性表达率增高，与无神经及脉管受侵或淋巴结转移者有显著差异（P〈0．05）。结论：CK-19mRNA的表达与神经及脉管受侵以及淋巴结转移有关，与激素受体及HER2表达无关。随着肿瘤分期的增高，微转移检出率将升高。

Study of the association between the expression of CK-19mRNA and breast cancer

Objective：To evaluate the clinical significance of the expression of cytokeratin 19 mRNA in peripheral blood as well as its relationship with surgery, chemotherapy and pathology. Methods：Peripheral blood samples were analyzed from 60 patients with breast cancer（ stage Ⅱ-Ⅲ ） at the times of pre-and post-operation. Twenty patients of breast benign tumors were choosed for control group. FQ-PCR was used to detect the expression of cytokeratin 19 mRNA in peripheral blood. Results：The detection for CK-19 mRNA in peripheral blood samples from 20 patients of breast benign tumors turned out to be negative. CK-19 mRNA were detected in 18 （ 30.0% ） of 60 patients pre-operation （ which had significant difference with control group, P 〈 0. 05 ）, 15 （ 25.0% ） of 60 patients in a week after operation, 8 （ 13.33% ） of 60 patients after one cycle of adjuvant chemotherapy, The positive rate of the mierometastasis in stage Ⅲ was higher than stage Ⅱ （P 〈0. 05）. The expression of CK-19 mRNA had no relation to estrogen receptor（ ER）, progestogen receptor（PR） and HER2 status. Its expression had relation to invasion in brood vessel, nerve and metastasis in lymph nodes. Conclusion：The expression of CK-19 mRNA has no relation to ER, PR and HER2 status, except for invasion in blood vessel, nerve and metastasis in lymph nodes. The positive rate of the micrometastasis has a rising trend along with the level of tumor＇s staging increasing.