乳腺癌患者外周血潜伏肿瘤细胞检测对预后判断的价值

Detection of latent tumor cells in the peripheral blood for the judgment of prognosis in patients with breast cancer

目的:以黑色素瘤抗原-A3(MAGE-A3)基因mRNA为特异性标记物,检测乳腺癌患者外周血中的肿瘤细胞,并探讨其意义。方法:采集南京医科大学第一附属医院2002-11/2003-0940例乳腺癌患者及20例非肿瘤疾病患者的外周血,用巢式RT-PCR方法检测外周血单核细胞(PBMC)中MAGE-A3基因mRNA。同时用RT-PCR方法检测乳腺癌患者肿瘤组织中上述MAGE基因的表达。结果:18%(7/40)乳腺癌患者的PBMC中可检测到MAGE-A3基因的mRNA,而相应乳腺癌组织MAGE-A3的表达率为23%(9/40),癌旁组织、乳腺癌组织中不表达MAGE-A3基因的病例以及20例非肿瘤疾病患者的PBMC中均未测出MAGE-A3基因mRNA。乳腺癌患者PBMC中两种MAGE基因mRNA的检出率与肿瘤TNM分期密切相关。结论:MAGE-A3基因mRNA可作为特异性肿瘤标记物用于检测乳腺癌患者PBMC中的乳腺癌细胞,巢式RT-PCR的敏感性及特异性较高,其检测结果可能有助于判断乳腺癌患者的预后。

AIM:To detect tumor cells in the peripheral blood of patients with breast cancer by using the mRNA of the melanoma antigen A3(MAGE A3) genes as specific tumor markers and investigate the significance of MAGE A3.METHODS:Peripheral blood was obtained from 40 breast cancer patients and 20 patients with benign diseases in the First Affiliated Hospital of Nanjing Medical University from November 2002 to September 2003.The mRNA of the MAGE A3 genes in the peripheral blood mononuclear cells(PBMCs) was detected by nested RT PCR.The expression of MAGE genes in the tumor tissues of these breast cancer patients was also detected by RT PCR.RESULTS:Of the 40 breast cancer patients,MAGE A3 mRNA were positive in 18% (7/40) of PBMCs and 23 % (9/40) of breast cancer tissues.MAGE A3 mRNA was not detected in the PBMCs from the patients whose tumors did not express the MAGE A3 genes,nor in the PBMCs from the 20 patients with benign diseases.The detection rate of two kinds of MAGE A3 mRNA in the PBMCs of breast cancer patients was closely correlated with the TNM staging.CONCLUSION:MAGE A3 mRNA can be used as specific tumor markers for the detection of the breast cancer cells in the PBMCs of patients,and the detection results may be helpful to evaluate the prognosis of breast cancer patients,because of the high sensitivity and specificity of nested RT PCR.