摘要
目的探讨非小细胞肺癌(non-smallcelllungcancer,NSCLC)患者纵隔淋巴结和外周血中黏蛋白-1基因(MUC1mRNA)作为肺癌微转移标志的可行性。方法应用逆转录聚合酶链反应(RT-PCR)技术,首先检测30例肺良性病变患者的外周血及其67枚纵隔淋巴结,以及30枚病理报告为NSCLC的纵隔淋巴结的MUC1mRNA,以证实RT-PCR技术的敏感度和特异度;然后检测158例NSCLC患者的外周血和97例手术患者的病理报告阴性的296枚纵隔淋巴结的MUC1mRNA的表达,以了解和比较NSCLC患者的外周血和纵隔淋巴结肺癌微转移情况。结果在30例肺良性病变患者外周血中未检测到MUC1mRNA,158例NSCLC患者有49例在外周血中检测到MUC1mRNA,阳性率为31.0%,两者差异显著(P<0.01);经χ2检验,Ⅰ、Ⅱ期NSCLC患者的外周血中MUC1mRNA阳性率无明显差异(P>0.05),Ⅰ期或Ⅱ期与Ⅲ期间差异显著(P<0.05),与Ⅳ期间差异明显(P<0.01),Ⅲ、Ⅳ期间差异显著(P<0.05)。对Ⅲa期以下的97例手术患者,术中所取的296枚病理报告为阴性的淋巴结进行MUC1mRNA检测,结果显示112枚为MUC1mRNA阳性,阳性率37.8%;30例肺良性病变的67枚淋巴结中有1枚MUC1mRNA阳性,假阳性率为1.5%,与前者比较阳性率的差异有统计学意义(P<0.01)。结论用RT-PCR法对患者淋巴结和外周血中MUC1mRNA的检测具有较高的敏感度和特异度,可作为肺癌微转移的一个诊断标准,同时与预后相关。
Objective To discuss the possibility of mucin-1 gene （MUC 1 mRNA） in mediastinal lymphnodes （MLNs） and peripheral blood as a symbol of occult metastasis in patients with non-small cell lung cancer （NSCLC）. Methods By reverse transcriptase-polymerase chain reaction （RT-PCR）, MUC1 mRNA in peripheral blood and in 67 MLNs from 30 patients with benign pulmonary diseases （ negative control group） and in 30 MLNs which had metastasis determined by routine pathologic examination（ positive control group） was detected ; MUC1 mRNA in peripheral blood in 158 patients with NSCLC and in 296 MLNs proven to be tumor-free by routine histopathologic examination from 97 NSCLC patients was detected （experimental group ）. Results MUC1 mRNA was not identified in peripheral blood in 30 patients with benign pulmonary diseases, but 49 specimens from 158 NSCLC patients were positive （positive rate 31.0% ） , there was significant difference between these two groups （ P 〈 0.01 ）. No significant difference between stage Ⅰ and stage Ⅱ NSCLC （ P 〉 0.05 ） , but the positive rate of MUC1 mRNA in stage Ⅲ and Ⅳ NSCLC was significantly higher than that in stage Ⅰ and Ⅱ （ P 〈 0. 05 or P 〈 0. 01 ）. One of 67 benign MLNs was identified to be MUC1 mRNA positive （ false positive 1.5% ） ,MUC1 mRNA in 112 MLNs from 296 MLNs in experimental group was positive （37.8%）, （P 〈0. 05）. Conclusion RT-PCR is a specific and sensitive method to detect MUC1 mRNA in MLNs and peripheral blood in NSCLC patients. MUC1 mRNA might be a valuable marker to determine micrometastases in NSCLC patients. It can provide important clinical information for prognosis and selection of appropriate treatment strategies.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2006年第24期2472-2474,共3页
Journal of Third Military Medical University
关键词
非小细胞肺癌
微转移
黏蛋白-1基因
淋巴结
外周血
non-small cell lung cancer
micrometastases
MUC1 mRNA
lymph node
peripheral blood
