外周血特异性肿瘤标志物mRNA表达诊断非小细胞肺癌微转移的研究

目的 研究非小细胞肺癌(NSCLC)患者外周血肿瘤标记物mRNA表达及联合检测的临床意义。 方法 采用逆转录聚合酶链反应(RT-PCR)检测47例NSCLC患者，26例肺良性疾病患者及20例健康对照者外周血细胞角蛋白19(CK19)、癌胚抗原（CEA）、粘蛋白-1(MUC1)、肺特异性 X基因(LUNX)mRNA的表达，分析它们作为NSCLC患者微转移标志物的可行性及与病理类型、分化程度、临床分期的关系。 结果 47例NSCLC患者外周血中CK19、CEA、MUC1、LUNX mRNA的阳性率分别为38.3％、44.7％、61.7％、57.4％；在良性肺疾病患者阳性率分别为3.8％、11.5％、0.0％、0.0％；健康组的外周血中没有四者的表达，差异有显著性； NSCLC组外周血CK19、MUC1、LUNX mRNA阳性表达率在鳞癌和腺癌患者比较差异无显著性，而腺癌患者与鳞癌患者中的CEAmRNA阳性率相比差异有显著性；MUC1、LUNX mRNA阳性率随分化程度升高而降低，差异有显著性，而CK19、CEAmRNA与肿瘤分化程度没有相关性；随着临床分期的加重，CK19、CEA、MUC1、LUNX mRNA阳性率均增高，而且，MUC1、LUNX mRNA阳性率差异有显著性。 结论 ①CK19、CEA、MUC1、LUNXmRNA可以作为检测NSCLC患者外周血微转移的标志物；②CEAmRNA在肺腺癌中的表达明显高于肺鳞癌，说明其对判断病理类型有一定意义；③MUC1、LUNXmRNA表达阳性率随TNM分期的增高而增加，随细胞分化程度的升高而降低。

The Evaluation of Clinical Significance by Measuring the Expression of Tumor Markers in Peripheral Blood of Patients with Non-small Cell Lung Cancer

【Abstract】Objective To evaluate the clinical significance by measuring the expression of tumor specific factors in peripheral blood of patients with non-small cell lung cancer. Methods The levels of mRNA of CK19,CEA,MUC1and LUNX were measured by RT-PCR in three groups including NSCLC group,lung benign diseases group and control group. According to pathological type, cell differentiation degree and clinical stage, the clinical significance was evaluated. Results Chi-square test showed that significant difference in the positive rates of mRNA of CK19,CEA,MUC1 and LUNX in NSCLC group,compared with the ones in lung benign diseases group and control group.The positive rates of mRNA of CEA showed more significant difference in adenocarcinoma of lung patients than squamous ones .With the cell differentiation degree decreasing and clinical stage deteriorating.The positive rates of mRNA of CK19,CEA,MUC1and LUNX all rised up,but the rates of mRNA of MUC1and LUNX had significant difference. Conclusions The levels of mRNA of CK19,CEA,MUC1and LUNX in peripheral blood can be as auxiliary index for diagnosing and monitoring NSCLC micrometastasis. The positive rates of mRNA of CEA was useful for pathologic diagnosis.and the ones of MUC1and LUNX might conduce to the cell differentiation degree decreasing and clinical stage deteriorating.