检测非小细胞肺癌病人外周血和骨髓中肿瘤细胞的临床意义

Evaluation of diagnosing disseminated tumor cells by nested RT-PCR in peripheral blood and bone marrow from patients with lung cancer

目的 探讨非小细胞肺癌 (NSCLC)外周血和骨髓中肿瘤细胞分子诊断的临床意义 ,以及二者相关性。方法 应用逆转录聚合酶链反应 (RT PCR)技术 ,对 31例肺癌病人、10例肺良性病变者和8名健康人外周血、骨髓中MUC1基因mRNA表达进行检测。结果 31例肺癌病人中 10例检测到外周血中有MUC1mRNA表达 ,检出率 32 3% ;7例骨髓中有表达 ,检出率 2 2 6 % ;二者之间存在显著正相关(P <0 0 5 ) ,且与肺癌组织学类型、细胞分化程度及P TNM分期均存在密切关系 (P <0 0 5 )。而肺良性病变者和健康人中均未检测到MUC1mRNA表达。结论 肺癌病人外周血和骨髓中存在常规方法检测不出的肿瘤细胞 ;应用巢式RT PCR法检测肺癌病人外周血和骨髓中MUC1mRNA表达 。

Objective To explore the clinical significance of molecular diagnosis of disseminated tumor cells (DTC) in peripheral blood and bone marrow from non-small cell lung cancer patients. Methods The MUC1 mRNA expression was detected in peripheral blood and bone marrow from 31 lung cancer patients by nested RT-PCR, with samples of 10 benign pulmonary lesion patients and 8 healthy adults as control. Results The positive rate of MUC1 mRNA were 32.3%(10/31) and 22.6%(7/31) in peripheral blood and bone marrow from lung cancer patients, respectively. Highly positive correlation existed between the two groups (P<0.05). The DTC in peripheral blood and bone marrow were closely related to the pathological classification, cell differentiation of the cancer and P-TNM stage of the disease (P<0.05). No MUC1 mRNA expression was found in the samples from patients with benign pulmonary lesion or healthy adult volunteers. The mean survival time of the 10 patients with DTC positive was 12 months, but the mean survival time of the 21 patients with DTC negative was 31 months (P<0.01). Conclusion The peripheral blood and bone marrow from patients with lung cancer possesses DTC that can not be detected by common methods. MUC1 mRNA might be a valuable marker to detect DTC in lung cancer patients. It can also provide important clinical information for the evaluation of prognosis and in the selection of appropriate treatment strategies.