CAJ | 학술논문

目的：检测肺癌外周血中细胞角蛋白19（CK19）mRNA、细胞角蛋白20（CK20）mRNA和基质金属蛋白酶-9（MMP-9）mRNA，探讨其作为判断晚期肺癌外周血检测其转移及判断预后的指标可行性。方法采用RT-PCR技术检测肺癌患者外周血中CK19mRNA、CK20mRNA、MMP-9mRNA的表达量，按表达阴阳性作为标准对其临床资料及短期疗效进行评估。结果 CK19、MMP-9及CK20表达阳性率化疗3疗程后均下降，其中CK19、MMP-9差异有统计学意义（P值0.003、0.007）；CK19mRNA、CK20mRNA和MMP-9mRNA表达阳性率化疗前后与性别，分化等均无相关性（P>0.05）；其中化疗前CK19mRNA表达Ⅳ期阳性率高于Ⅲ期患者（P=0.01）；腺癌患者CK19mRNA与MMP-9mRNA表达，化疗前表达阳性率明显高于鳞癌差异有统计学意义（P值为0.01、0.04）；化疗后腺癌CK19mRNA、CK20mRNA、MMP-9mRNA表达较鳞癌表达下降明显（P值为0.04、0.03、0.02）；治疗前CK20mRNA和MMP-9mRNA表达与有无疗效存在相关性，差异有统计学意义（P值为0.04、0.0.02），CK19mRNA表达无相关性。化疗后CK19mRNA、CK20mRNA表达与有无疗效存在相关性，差异有统计学意义（P值为0.01、0.02），MMP-9mRNA表达无相关性。结论通过CK19、CK20、MMMP-9mRNA表达检测，判断晚期肺癌患者化疗疗效，指导用药，提高晚期患者的生活质量及预后的监测的重要意义。
목적：검측폐암외주혈중세포각단백19（CK19）mRNA、세포각단백20（CK20）mRNA화기질금속단백매-9（MMP-9）mRNA，탐토기작위판단만기폐암외주혈검측기전이급판단예후적지표가행성。방법채용RT-PCR기술검측폐암환자외주혈중CK19mRNA、CK20mRNA、MMP-9mRNA적표체량，안표체음양성작위표준대기림상자료급단기료효진행평고。결과 CK19、MMP-9급CK20표체양성솔화료3료정후균하강，기중CK19、MMP-9차이유통계학의의（P치0.003、0.007）；CK19mRNA、CK20mRNA화MMP-9mRNA표체양성솔화료전후여성별，분화등균무상관성（P>0.05）；기중화료전CK19mRNA표체Ⅳ기양성솔고우Ⅲ기환자（P=0.01）；선암환자CK19mRNA여MMP-9mRNA표체，화료전표체양성솔명현고우린암차이유통계학의의（P치위0.01、0.04）；화료후선암CK19mRNA、CK20mRNA、MMP-9mRNA표체교린암표체하강명현（P치위0.04、0.03、0.02）；치료전CK20mRNA화MMP-9mRNA표체여유무료효존재상관성，차이유통계학의의（P치위0.04、0.0.02），CK19mRNA표체무상관성。화료후CK19mRNA、CK20mRNA표체여유무료효존재상관성，차이유통계학의의（P치위0.01、0.02），MMP-9mRNA표체무상관성。결론통과CK19、CK20、MMMP-9mRNA표체검측，판단만기폐암환자화료료효，지도용약，제고만기환자적생활질량급예후적감측적중요의의。
Objective To investigate the feasibility that CK19,CK20 and MMP-9mRNA are considered as the index to detect the metastasis of peripheral blood of patients with intermediate and advanced-stage lung cancer and judge the prognosis. Method The expression amount of CK19mRNA,CK20mRNA and MMP-9mRNA in peripheral blood of patients with lung cancer was measured by RT-PCR and clinical data and the short-term curative effect were evaluated according to the standard of positive and negative expression. Results Positive expression rates of CK19,MMP-9 and CK20 were decreased after 3 course of chemotherapy,of which,the differences of CK19 and MMP-9 had statistical significance(P=0.003 and P=0.007,respectively);the positive expression rate of CK19mRNA,CK20mRNA and MMP-9mRNA before and after chemotherapy was not correlative with gender and differentiation etc(P>0.05);the positive expression rate of CK19mRNA of patients in stage IV was higher than that of patients in stage III before chemotherapy(P=0.01);the difference of positive expression rates of CK19mRNA and MMP-9mRNA of adenocarcinoma patients before chemotherapy were obviously higher than that of squamous cell carcinomas patients,with statistically significant difference (P=0.01 and P=0.04,respectively);the expression of CK19mRNA,CK20mRNA and MMP-9mRNA of adenocarcinoma patients was decreased,more obviously than that of squamous cell carcinomas patients after chemotherapy (P=0.04,P=0.03 and P=0.02 respectively); expression of CK20mRNA and MMP-9mRNA before chemotherapy was correlative with existence and absence of curative effect,with statistically significant difference (P=0.04 and P=0.02 respectively),but this did not occur in expression of CK19mRNA; after chemotherapy,the expression of CK19mRNA and CK20mRNA was correlative with existence and absence of curative effect,with statistically significant difference (P=0.01 and P=0.02 respectively),but this did not occur in MMP-9mRNA expression. Conclusion Expressions of CK19, CK20 and MMMP-9mRNA can be detected for evaluating the curative effect of chemotherapy for intermediate and advanced-stage patients thus instructing the drug use.