CAJ | 학술논문

目的探讨早期乳腺癌患者外周血CK19 mRNA阳性细胞检测的临床意义及其预后价值.方法应用RT-PCR检测50例早期乳腺癌患者、24例良性乳腺病变患者及20名健康体检志愿者外周血有核细胞CK19 mRNA的表达,并根据基因标志物结果随访.结果早期乳腺癌患者术后辅助治疗前外周血有核细胞CK19 mRNA阳性率40.0%(20/50),与良性乳腺疾病患者[12.5%(3/24)]及健康体检志愿者[5%(1/20)]比较,差异均有统计学意义(P=0.018,P=0.004);外周血有核细胞CK19 mRNA阳性率与患者年龄、月经状况、TNM分期、肿瘤大小、淋巴结转移状况、病理分化、激素受体状况、Her-2、血清CA153、血清CEA水平异常升高无关(P＞0.05);20例外周血有核细胞CK19 mRNA阳性的患者中有11例随访期出现转移复发(P=0.002),中位无瘤生存期明显缩短(P=0.007).结论 CK19 mRNA可以作为循环肿瘤细胞基因标志物.检测CK19 mRNA阳性循环肿瘤细胞,可能作为早期乳腺癌术后判断复发转移的辅助指标.
목적 탐토조기유선암환자외주혈CK19 mRNA양성세포검측적림상의의급기예후개치.방법 응용RT-PCR검측50례조기유선암환자、24례량성유선병변환자급20명건강체검지원자외주혈유핵세포CK19 mRNA적표체,병근거기인표지물결과수방.결과 조기유선암환자술후보조치료전외주혈유핵세포CK19 mRNA양성솔40.0%(20/50),여량성유선질병환자[12.5%(3/24)]급건강체검지원자[5%(1/20)]비교,차이균유통계학의의(P=0.018,P=0.004);외주혈유핵세포CK19 mRNA양성솔여환자년령、월경상황、TNM분기、종류대소、림파결전이상황、병리분화、격소수체상황、Her-2、혈청CA153、혈청CEA수평이상승고무관(P＞0.05);20예외주혈유핵세포CK19 mRNA양성적환자중유11례수방기출현전이복발(P=0.002),중위무류생존기명현축단(P=0.007).결론 CK19 mRNA가이작위순배종류세포기인표지물.검측CK19 mRNA양성순배종류세포,가능작위조기유선암술후판단복발전이적보조지표.
Objective To study the clinical and prognostic value of CK19 mRNA-positive circulating tumor cells in early breast cancer patients. Methods We analyzed the peripheral blood in 50 patients with early breast cancer after surgery and before the initiation of any adjuvant treatment for the presence of CK19 mRNA-positive circulating tumor cells using a nest reverse polymerase chain reaction assay. All patients were followed up. Results CK19 mRNA-positive cells were detected in 40.0 %(20/50) of patients with early breast cancer, 12.5 %(3/24) of patients with breast benign lesions, but 5 %(1/20) in healthy individuals (P =0.017,P =0.004); 11 to 20 of them relapsed during the follow-up period (P =0.002). There was no significant association between the detection of CK19 mRNA-positive cell and the patients' menstrual status, tumor stage, tumor size, etc (P ＞0.05). Detection of peripheral-blood CK19 mRNA-positive cells was associated with reduced median relapse-free interval in early breast cancer patients (P =0.007). Conclusion CK19 mRNA is one of the molecular markers for the detection of circulating tumor cells in early breast cancer. Detection of peripheral blood CK19 mRNA-positive cells might be an important predictive value as a marker of relapse in early breast cancer patients.