乳腺癌患者辅助化疗前后外周血中ＰＩＰｍＲＮＡ表达变化的研究

目的：通过检测乳腺癌患者辅助化疗前后外周血中泌乳素诱导蛋白（ＰＩＰ）ｍＲＮＡ的表达变化，探讨术后辅助化疗对乳腺癌血液微转移的影响。方法：收集沈阳军区总医院肿瘤科２００６年７月～２００７年９月经术后病理证实的乳腺癌患者５０例，在化疗前及接受２～３周期辅助化疗后应用巢式ＲＴ-ＰＣＲ方法检测这些乳腺癌患者外周血中ＰＩＰｍＲＮＡ的表达。另取乳腺纤维腺瘤１０例、健康志愿者１０例、胃癌５例、结直肠癌５例、食管癌５例、肺癌５例、卵巢癌５例作阴性对照。结果：５０例乳腺癌患者外周血标本中，化疗前１７例ＰＩＰｍＲＮＡ阳性的患者，化疗２～３周期后１３例ＰＩＰｍＲＮＡ转为阴性，转阴率７６.５％（１３／１７），化疗前ＰＩＰｍＲＮＡ表达阴性的患者在化疗后无１例阳性，化疗前后差异有统计学意义（Ｐ＝０.００１）。而对照组４５例外周血标本中均未检出ＰＩＰｍＲＮＡ的表达。ＰＩＰｍＲＮＡ的阳性表达与淋巴结转移、ＴＮＭ分期有关，而与患者年龄、肿瘤大小、ＥＲ、ＰＲ及Ｃ-ｅｒｂＢ-２等表达无关。结论：乳腺癌患者接受术后辅助化疗能够降低血液ＰＩＰｍＲＮＡ的阳性率，有望减少乳腺癌血液微转移的发生。

Research on changes of PIP mRNA expression in the peripheral blood of patients with breast cancer before and after adjuvant chemotherapy

Objective：To detect the changes of prolactin-inducible protein（PIP） mRNA expression in peripheral blood of patients with breast cancer before and after adjuvant chemotherapy, and explore the impact of postoperative adjuvant chemotherapy on mi- crometastases in breast cancer. Methods：Fifty patients diagnosed as breast cancer histopatbologically were collected in the Department of Oncology, General Hospital of Shenyang Military Area from July 2006 to September 2007. PIP mRNA expression in peripheral blood of these patients were detected by nested RT-PCR before and after 2 to 3 cycles of adjuvant chemotherapy. Ten cases of breast fibroade- noma, 10 healthy volunteers, 5 cases of stomach cancer, 5 cases of colorectal cancer, 5 cases of esophageal cancer, 5 cases of lung cancer and 5 cases of ovarian cancer were taken as negative control. Results： In peripheral blood specimens of 50 breast cancer cases, PIP mRNA were detected positive in 17 cases before chemotherapy, among them PIP mRNA of 13 cases were reverted to negativity after 2 to 3 cycles of chemotherapy, with the negative rate of 76. 5 % （13/17 ）. No case with PIP mRNA-negative expression was found posi- tive after chemotherapy. There was a statistical significance between pre and post chemotherapy（ P = 0. 001 ）. PIP mRNA positive ex- pression in peripheral blood was associated with lymph node metastasis status and TNM stage, while it had nothing to do with patients＇ age, tumor size, ER, PR and C-erbB-2 expression, etc. Conclusion：PIP mRNA-posifive rate in peripheral blood could be reduced after adjuvant chemotherapy, which is expected to reduce the incidence of blood micrometastases in breast cancer patients.