乳腺癌患者CK19mRNA表达的意义及辅助化疗对骨髓微转移的影响
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张丽丽

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The significance of CK19mRNA expression in patients with breast cancer and the effect of adjuvant chemotherapy on bone marrow micrometastasis
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    摘要:

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    目的 探讨乳腺癌患者外周血、淋巴结和骨髓的微转移情况,以及辅助化疗对骨髓微转移的影响。
    方法 采用RTPCR技术同时检测可手术的69例乳腺癌患者的外周血、淋巴结和骨髓中CK19mRNA的表达,并观察辅助化疗对骨髓微转移的影响。
    结果 骨髓微转移24例(34.8%),外周血CK19mRNA阳性11例(15.9%)。淋巴结微转移阳性40例(58.0 %),其中淋巴结病理学检查阳性的35例中, 32例(91.4%)淋巴结微转移阳性,在淋巴结病理学检查阴性的34例中,8例(23.5%)淋巴结微转移阳性。淋巴结微转移阳性的40例中,18例(45.0%)骨髓微转移阳性。24例骨髓微转移阳性的患者在接受6个周期的CAF方案辅助化疗后, 有7例骨髓微转移转阴(29.2%)。
    结论 CK19mRNA的表达可作为评价乳腺癌微转移的指标。外周血微转移的检测,其敏感性和特异性较骨髓差;骨髓微转移的检测可作为评价辅助化疗敏感性的指标之一。

    Abstract:

    Abstract:Objective To study the micrometastasis in peripheral blood, lymph node and bone marrow in patients with breast cancer and the effect of adjuvant chemotherapy on bone marrow micrometastasis.
    Methods RTPCR technique was used to simultaneously detect the micrometastasis in peripheral blood, lymph node and bone marrow in 69 patients with operable breast cancer, and the effect of adjuvant chemotherapy on bone marrow micrometastasis was also investigated.
    Results The positivity of bone marrow micrometastasis tested by RTPCR in breast cancer patients was 34.8%. The circulating tumor cells were found in 11 patients (15.9%). Lymph node metastasis was positive in 35 cases, out of the 35 nodepositive cases, 32 cases(91.4%) were lymph node micrometastasis, out of the 34 nodenegative cases, eight cases(23.5%) were lymph node micrometastasis. Seven of 24 cases(29.2%) of bone marrow micrometastasis positive patients became negative after receiving six cycles of CAF adjuvant chemotherapy.
    Conclusions Detection of CK19mRNA by RTPCR is a sensitive and specific method of assessing micrometastasis in patients with breast cancer. Compared with the detection of bone marrow micrometastasis , the technique to detect the micrometastasis in peripheral blood is less sensitive or specific. The detection of bone marrow micrometastasis is a sensitive index to assess the effect of adjuvant chemotherapy.

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张丽丽 , 孙靖中 , 顾禾 ,时昌文 ,曹莉莉.乳腺癌患者CK19mRNA表达的意义及辅助化疗对骨髓微转移的影响[J].中国普通外科杂志,2007,16(1):16-.
DOI:10.7659/j. issn.1005-6947.2007.01.016

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  • 收稿日期:2006-03-05
  • 最后修改日期:2006-11-13
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  • 在线发布日期: 2007-01-25