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目的 :了解卵巢癌患者除直接侵袭或植入体腔外 ,是否还通过血液循环的渠道而转移。方法 :以角蛋白19(K- 19) - m RNA及癌胚抗原 (CEA) - m RNA两基因的表达为标记物 ;应用巢式—反转录聚合酶链反应 (Nested-RT- PCR)进行扩增 ,经 PAGE后进行观察。结果 :5 1例卵巢癌的骨髓标本中 2 1例 (4 1.18%) K- 19为阳性 ,CEA阳性 4例 (7.84%) ,双阳性 5例 (9.8%) ;K- 19加双项阳性为 2 6例 (5 0 .98%) ,阴性 2 1例 (4 1.2 %)。 2 2例周围血中 K-19阳性 3例 (13.6 3%)、CEA1例 (4 .5 5 %) ,无双阳性 ,阴性 18例 (81.82 %)。经 χ2分析患者骨髓标本结果与正常对照间有显著性差异 (P<0 .0 0 5 ) ,而患者周围血与对照组间则无明显差异 (P>0 .0 5 )。临床分期之早晚及年龄之增长 ,其阳性率有上升趋势。病理型态之恶性程度高者微转移率较恶性程度低者为高。结论 :以 Nested- RT- PCR对 K-19- m RNA表达的检测来判断卵巢癌的微转移是一种很灵敏的方法 ,凡阳性者必须及早采用较长时间化疗 ,并定期复查以观疗效以防复发
Objectives: To understand whether patients with ovarian cancer transfer through the channels of blood circulation, in addition to direct invasion or implantation outside the body cavity. Methods: The expression of keratin 19 (K-19)-m RNA and CEA-m RNA was used as a marker; nested-RT-PCR was used. Amplification was performed after PAGE. RESULTS: Of the 51 cases of ovarian cancer, 21 cases (4 1.18%) were positive for K- 19, 4 cases were CEA positive (7.84%), and 5 cases were double positive (9.8%); K- 19 plus double positive. It was 26 cases (50.98%) and negative 2 cases (41.2%). Among 22 cases of peripheral blood, 3 cases were positive for K-19 (13.6 3%) and 1 case was CEA (4.55%). There were no positive and negative cases, and 18 cases (81.82%) were negative. There was a significant difference between the bone marrow samples of patients analyzed by χ2 and normal controls (P<0.05), but there was no significant difference between patients’ peripheral blood and control groups (P>0.05). As soon as the clinical stage is on and the age increases, the positive rate has an upward trend. The higher the degree of malignancy of the pathological type, the higher the micrometastasis rate than the lower degree of malignancy. Conclusion: The detection of K-19-m RNA expression by Nested-RT-PCR is a sensitive method to determine the micrometastasis of ovarian cancer. All positive patients must be treated with chemotherapy for a longer period of time. To prevent recurrence