MAGE基因在检测非小细胞肺癌淋巴结微转移中的应用

Detection of occult micrometastasis using MAGE genes in lymph nodes of patients with non-small cell lung cancer

背景与目的MAGE基因是肿瘤特异性基因,本研究检测了MAGE1、2、3、4基因mRNA在非小细胞肺癌(NSCLC)淋巴结中的表达情况,以分析MAGE基因在检测NSCLC淋巴结微转移中的意义。方法采用逆转录-聚合酶链反应(RTPCR)方法检测53例NSCLC患者的111组淋巴结中MAGE1、2、3、4mRNA的表达。结果应用常规病理检查和应用RTPCR技术检测MAGE基因mRNA表达的淋巴结转移阳性率分别为27.9%(31/111)和41.4%(46/111),差异有显著性(P<0.05)。80组常规病理检查阴性淋巴结中至少有一种MAGE基因表达的淋巴结有19组,阳性率是23.8%(19/80)。31组常规病理检查阳性淋巴结标本中至少有一种MAGE基因表达的阳性率是87.1%(27/31)。非肺癌患者淋巴结四种MAGE基因表达均为0。结论应用RTPCR法检测非小细胞肺癌淋巴结中MAGE1、2、3、4基因mRNA的表达,有助于诊断淋巴结微转移,提高肺癌TNM分期的准确性。

Background and objective Melanoma antigen genes (MAGE genes) are tumor specific genes. In this study the expressions of MAGE-1, -2, -3 and -4 genes in lymph nodes of patients with non-small cell lung cancer (NSCLC) at mRNA level were investigated and the role of MAGE genes was analyzed in the diagnosis of occult micrometastasis in lymph nodes of patients with NSCLC. Methods One hundred and eleven stations of lymph nodes from 53 patients with NSCLC were studied to detect mRNA for MAGE-1, -2, -3 and -4 genes by using reverse transcription-polymerase chain reaction (RT-PCR) assay. Results The expression rate in samples of lymph nodes using RT-PCR (41.4%, 46/111) was significantly higher than that using routine histopathological examination (27.9%, 31/111). Of the 80 stations of lymph nodes without invasion of the tumor confirmed by routine histopathological examination, at least one of these genes was expressed in (23.8%) (19/80) out of the samples. Of the 31 stations of lymph nodes with invasion of the tumor confirmed by routine histopathological examination, at least one of these MAGE genes was expressed in 87.1% (27/31) out of the samples. In the lymph nodes of the patients with non-cancerous diseases, the MAGE-1, -2, -3 and -4 were not expressed at mRNA level. Conclusion Micrometastasis in lymph nodes of patients with NSCLC could be diagnosed by investigating the expressions of MAGE genes at mRNA level. Detection of MAGE-1, (-2,) -3 and -4 might be helpful to diagnoze micrometastasis in lymph node and to increase the accuracy of TNM stages in NSCLC.