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[目的]探讨细胞角蛋白19(cytokeratin 19,CK 19)mRNA,细胞角蛋白20(cytokeratin20,CK20)mRNA,基质金属蛋白酶9(matrix metalloproteinase 9,MMP9)mRNA,尿激酶型纤溶酶原激活物(urokinase plasminogen activator,uPA)mRNA在肺腺癌胸腔积液患者发生转移的作用。[方法]采用PCR技术和荧光定量RT-PCR检测47例经病理学确诊的肺腺癌合并胸腔积液患者中的CK19、CK20、MMP9、uPA mRNA水平。[结果]47例肺腺癌合并恶性胸腔积液患者CK19 mRNA 0~52 700copies/ml,CK20 mRNA 0~62 900copies/ml。肺腺癌恶性胸腔积液患者合并骨转移者CK20mRNA较无骨转移患者高(1 060 copies/ml vs 566.7 copies/ml,P=0.045)。伴有区域淋巴结转移患者uPA mRNA较无区域淋巴结转移患者高(553.4 copies/ml vs 173.7 copies/ml,P=0.048)。[结论]外周血CK20 mRNA高表达可能使肺腺癌合并胸膜转移患者更易发生骨转移。uPA mRNA表达可能与肺腺癌胸膜转移患者存在区域淋巴结转移相关。
[Objective] To investigate the expression of cytokeratin 19 (CK 19) mRNA, cytokeratin 20 (CK20) mRNA, matrix metalloproteinase 9 (MMP9) mRNA and urokinase plasminogen activator (urokinase plasminogen activator, uPA) mRNA in patients with pleural effusion of lung adenocarcinoma. [Method] The levels of CK19, CK20, MMP9 and uPA mRNA in 47 cases of lung adenocarcinoma with pleural effusion confirmed by pathology were detected by PCR and fluorescent quantitative RT-PCR. [Results] CK19 mRNA 0 ~ 52 700copies / ml, CK20 mRNA 0 ~ 62 900copies / ml in 47 cases of lung adenocarcinoma with malignant pleural effusion. Patients with malignant pleural effusion of lung adenocarcinoma had higher CK20mRNA in bone metastases than those without bone metastases (1 060 copies / ml vs 566.7 copies / ml, P = 0.045). The level of uPA mRNA in patients with regional lymph node metastasis was significantly higher than that in patients without regional lymph node metastasis (553.4 copies / ml vs 173.7 copies / ml, P = 0.048). [Conclusion] The high expression of CK20 mRNA in peripheral blood may make bone metastasis more likely to occur in patients with lung adenocarcinoma complicated with pleural metastasis. uPA mRNA expression may be associated with regional lymph node metastasis in patients with pleural metastasis of lung adenocarcinoma.