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目的 通过分子生物学与常规免疫组化法比较 ,以寻求更好地检测乳腺癌微小转移的方法。方法 采用逆转录多聚酶链反应 (RT PCR)方法检测 2 6例乳腺癌患者的外周血与骨髓中细胞角蛋白 19(KT19)mRNA的表达 ,并用链酶亲和素 生物素 过氧化物酶复合物 (SABC)免疫组化法检测乳腺癌患者骨髓涂片中上皮膜抗原 (EMA)。结果 2 6例外周血中KT19mRNA阳性 4例(15 4% ) ,骨髓阳性 10例 (38 4% )。免疫组化结果显示 2 6例骨髓中有 7例 (2 6 9% )EMA阳性 ,其KT19mRNA都阳性 ,有 3例 (11 5 % )免疫组化结果阴性而KT19mRNA阳性。结论 RT PCR方法检测KT19mRNA是一种比较敏感的方法 ,免疫组化也是一种比较可靠的检测方法 ,外周血中KT19mRNA的检测结果还不能完全取代骨髓的微小转移情况
Objective To compare the methods of molecular biology with routine immunohistochemistry in order to seek better methods for the detection of micrometastasis in breast cancer. Methods Reverse transcription polymerase chain reaction (RT PCR) was used to detect the expression of cytokeratin 19 (KT19) mRNA in peripheral blood and bone marrow of 26 breast cancer patients and streptavidin biotin peroxidase complex was used. (SABC) immunohistochemistry was used to detect epithelial membrane antigen (EMA) in bone marrow smears of breast cancer patients. RESULTS: KT19 mRNA was positive in 4 cases (15 4%) and bone marrow was positive in 10 cases (38 4%). The immunohistochemical results showed that 7 out of 26 cases of bone marrow (26.9%) were positive for EMA and their KT19 mRNA was positive. Three (11.5%) had immunohistochemically negative results and positive KT19 mRNA. Conclusion The RT PCR method is a sensitive method to detect KT19 mRNA. Immunohistochemistry is also a reliable method. The results of KT19 mRNA detection in peripheral blood can not completely replace the micrometastasis of bone marrow.