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目的探讨检测肺癌患者外周血和骨髓微转移的特异性、敏感性及临床意义。方法应用巢式RT-PCR技术,检测59例肺癌患者、11例肺部良性病变患者和20例健康人外周血、骨髓中CK19 mRNA表达。结果巢式RT-PCR检测技术的敏感性达到10-6。59例肺癌患者中,20例检测出外周血微转移,13例检测出骨髓微转移,其阳性检出率分别为33.9％(20/59)和22.0％(13/59),二者有显著正相关(P<0.05)。肺癌患者外周血和骨髓微转移与肺癌组织学类型、细胞分化程度及P-TNM分期均存在密切关系(P<0.05或P<0.01)。肺良性病变患者、健康人外周血和骨髓中均未检测出CK19 mRNA表达。结论肺癌患者外周血和骨髓中均存在用常规方法检测不出的微转移;应用巢式RT-PCR技术检测肺癌患者外周血和骨髓中CK19 mRNA表达,对肺癌微转移的分子诊断具有重要的理论意义和临床应用前景。
Objective To investigate the specificity, sensitivity and clinical significance of detecting micrometastasis in peripheral blood and bone marrow of patients with lung cancer. Methods The expression of CK19 mRNA in peripheral blood and bone marrow of 59 patients with lung cancer, 11 patients with benign lung disease and 20 healthy people were detected by nested RT-PCR. Results The sensitivity of nested RT-PCR was 10-6.59 cases of lung cancer, peripheral blood micrometastases were detected in 20 cases and bone marrow micrometastases were detected in 13 cases, the positive rates were 33.9% (20 / 59) and 22.0% (13/59) respectively. There was a significant positive correlation between them (P <0.05). Lung cancer patients with peripheral blood and bone marrow micrometastasis and histological types of lung cancer, cell differentiation and P-TNM staging are closely related (P <0.05 or P <0.01). CK19 mRNA expression was not detected in peripheral blood and bone marrow of healthy patients and patients with benign lung diseases. CONCLUSIONS: Micrometastases undetectable by routine methods exist in both peripheral blood and bone marrow of patients with lung cancer. Using nested RT-PCR to detect the expression of CK19 mRNA in peripheral blood and bone marrow of patients with lung cancer has an important theory on the molecular diagnosis of lung cancer micrometastasis Significance and clinical application prospects.