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目的通过检测非小细胞肺癌(NSCLC)患者外周血CK19 mRNA的表达,探讨其对外周血微转移的意义。方法 NSCLC患者170例,肺良性疾病患者20例和健康志愿者20例作为对照,均在治疗前抽取外周血,通过RT-PCR法检测CK19 mRNA的表达,结合随访资料和生存时间进行分析。结果 NSCLC患者的CK19 mRNA阳性率为46.5%(79/170),对照组为5%(2/40),差异有统计学意义(P<0.01)。外周血CK19 mRNA阳性患者的远处转移发生率为32.4%(24/74),高于阴性患者的发生率(17.1%,14/82;P<0.05)。全组无瘤生存时间为37个月,外周血CK19 mRNA阳性组和阴性组的无瘤生存时间分别为30个月和45个月(P=0.003)。结论 CK19 mRNA是一种检测NSCLC外周血微转移的较好方法,对判断病程发展和指导临床治疗具有重要意义,是预测复发转移和预后不良的辅助指标。
Objective To detect the expression of CK19 mRNA in peripheral blood of patients with non-small cell lung cancer (NSCLC) and to explore its significance on peripheral blood micrometastasis. Methods 170 patients with NSCLC, 20 patients with benign lung disease and 20 healthy volunteers were selected as control. Peripheral blood was collected before treatment. The expression of CK19 mRNA was detected by RT-PCR. The follow-up data and survival time were analyzed. Results The positive rate of CK19 mRNA in NSCLC patients was 46.5% (79/170) and that in the control group was 5% (2/40), the difference was statistically significant (P <0.01). The incidence of distant metastasis in peripheral blood CK19 mRNA positive patients was 32.4% (24/74), which was higher than that in negative patients (17.1%, 14/82; P <0.05). The overall tumor-free survival time was 37 months, and the tumor-free survival time of CK19 mRNA positive group and negative group were 30 months and 45 months respectively (P = 0.003). Conclusion CK19 mRNA is a better method to detect micrometastasis in peripheral blood of NSCLC. It is of great significance in judging the course of disease and guiding the clinical treatment. It is an auxiliary index to predict recurrence, metastasis and poor prognosis.