CAJ | 학술논문

目的：研究早期宫颈癌患者外周血CK19 mRNA检测及其临床意义．方法昆明医科大学第三附属医院妇科30例早期（ⅠA2～ⅡA）宫颈癌患者为实验组，15例子宫肌瘤患者和15例健康志愿者为阴性对照组，15例晚期（ⅡB～ⅢB）宫颈癌患者为阳性对照组．收集外周血样本，qRT-PCR技术检测外周血CK19表达水平的变化，分析其与临床病理参数、预后的相关性．结果实验组外周血中CK19表达水平与阴性对照组、阳性对照组比较，差异有统计学意义（＜0.01）；30例宫颈癌患者手术前外周血 CK19 mRNA阳性检出率为30%（9/30），与淋巴结转移情况、肌层浸润、术后病理高危因素密切相关（＜0.05），而与患者临床病理因素如年龄、临床分期（FIGO）、肿瘤细胞分化程度、肿瘤直径、病理类型之间均无明显相关性（＞0.05）．结论宫颈癌根治术前外周血CK19 mRNA表达水平可作为诊断早期宫颈癌循环肿瘤细胞的标志物，能够弥补影像学、肿瘤标志物等检查不足，可能作为预测复发转移、判断预后的辅助指标，为术后辅助治疗方案选择、判定预后提供依据．
목적：연구조기궁경암환자외주혈CK19 mRNA검측급기림상의의．방법곤명의과대학제삼부속의원부과30례조기（ⅠA2～ⅡA）궁경암환자위실험조，15례자궁기류환자화15례건강지원자위음성대조조，15례만기（ⅡB～ⅢB）궁경암환자위양성대조조．수집외주혈양본，qRT-PCR기술검측외주혈CK19표체수평적변화，분석기여림상병리삼수、예후적상관성．결과실험조외주혈중CK19표체수평여음성대조조、양성대조조비교，차이유통계학의의（＜0.01）；30례궁경암환자수술전외주혈 CK19 mRNA양성검출솔위30%（9/30），여림파결전이정황、기층침윤、술후병리고위인소밀절상관（＜0.05），이여환자림상병리인소여년령、림상분기（FIGO）、종류세포분화정도、종류직경、병리류형지간균무명현상관성（＞0.05）．결론궁경암근치술전외주혈CK19 mRNA표체수평가작위진단조기궁경암순배종류세포적표지물，능구미보영상학、종류표지물등검사불족，가능작위예측복발전이、판단예후적보조지표，위술후보조치료방안선택、판정예후제공의거．
Objective To investigate the detection of early cervical cancer patient's peripheral blood CK19 mRNA and its clinical significance. Methods 30 early (ⅠA2~ⅡA) cervical cancer patients from the department of gynecological tumors in the third affiliated hospital of Kunming Medical University were selected as experimental group, 15 patients with uterine myoma and 15 healthy volunteers as negative control group,15 advanced (ⅡB~ⅢB) cervical cancer patients as positive control group. Peripheral blood samples before receiving radical resection of experimental group,and the same samples before treatment of control groups were collected. The change of relative expression level and positive rate of peripheral blood CK19 was analyzed using qRT-PCR technique, and its correlation with clinicopathological parameters and prognosis was further analyzed. Results There was significant difference in relative expression level of CK19 mRNA in the peripheral blood between experimental group and control groups ( <0.001) . And the positive rate of CK19 in the peripheral blood from 30 patients with early cervical cancer before operation in the experimental group was 30% (9/30) . Furthermore, CK19 mRNA positive rate before surgery was correlated with lymph node metastasis, muscularis invasion and pathologic risk factors for postoperative ( <0.05) . There were no significant correlation between CK19 mRNA positive rate and other clinical and pathological features such as age,clinical stage (FIGO),tumor cell differentiation,tumor size,pathological type and etc ( > 0.05) . Conclusions CK-19 mRNA is a specific and suitable molecular marker for the detection of circulating tumor cells in early cervical cancer. Detection of peripheral blood CK19 mRNA expression before receiving radical hysterectomy in patients with early cervical cancer can also make up for the disadvantage of other methods such as the imaging, tumor marker detection. Most important of all, it can provide the basis for choosing a proper adjuvant therapy post-operation and estimating the relapse and prognosis.