目的探讨乳腺癌骨髓微转移的临床特点和检测方法及新辅助化疗治疗乳腺癌骨髓微转移的疗效。方法手术治疗的乳腺癌患者63例,采用免疫组化SP法,用EMA,细胞角蛋白19cK-l9mRNA表达水平检测其骨髓微转移情况,分析其临床特点,并以骨髓微转移为指标,评价新辅助化疗对阳性患者的影响。结果 63例中,检出骨髓微转移19例,阳性率为30.16%。临床Ⅲ期患者骨髓微转移率明显高于Ⅰ～Ⅱ期患者,阳性患者接受新辅助化疗后,转阴率达70.8%。结论乳腺癌是一种全身性疾病,即使在临床早期也有相当比例微转移,新辅助化疗对抑制骨髓微转移有效,可以指导化疗方案的选择,并可能对预防术后复发和转移起重要作用。细胞角蛋白19cK-l9mRNA表达水平的检测具有确切的预测价值,可有效监测乳腺癌微转移和疗效。 Objective To investigate the clinical features and detection methods of bone marrow micrometastasis in breast cancer and the effect of neoadjuvant chemotherapy on bone marrow micrometastasis in breast cancer. Methods Sixty-three patients with breast cancer were treated by immunohistochemical SP method. The bone marrow micro-metastasis was detected by EMA and cytokeratin 19cK-l9mRNA expression. The clinical features were analyzed. Effect of adjuvant chemotherapy on positive patients. Results Of the 63 cases, 19 cases of bone marrow micrometastases were detected, the positive rate was 30.16%. The rate of bone marrow micrometastases in patients with stage Ⅲ was significantly higher than those in patients with stage Ⅰ ~ Ⅱ, and the rate of negative conversion was 70.8% after receiving neoadjuvant chemotherapy. Conclusions Breast cancer is a systemic disease. Even if there is a considerable proportion of micrometastases in early clinical stage, neoadjuvant chemotherapy is effective in inhibiting bone marrow micrometastasis, which can guide the choice of chemotherapy regimens and may play an important role in preventing postoperative recurrence and metastasis. The detection of cytokeratin 19cK-l9mRNA expression level has definite predictive value, which can effectively monitor the micro-metastasis and curative effect of breast cancer.