乳腺癌患者术后腋窝引流液中C-metmRNA检测的意义

Significance of C-met mRNA Detection in Axillary Drainage After Operations for Breast Cancer

背景与目的:研究原癌基因C-met在乳腺癌患者术后腋窝引流液中表达的临床意义。材料与方法:用RT-PCR法检测32例乳腺癌患者行乳腺癌简化根治术后腋窝引流液中C-metmRNA表达,并以三磷酸甘油醛脱氢酶基因(humanglyceraldehydes-3-phosphatedehydrogenase,hGAPDH)为内参照。分析C-met阳性表达与肿瘤大小、腋窝淋巴结转移个数以及肿瘤雌激素受体(Estrogenreceptor,ER)和孕激素受体(Progesteronereceptor,PR)的相关性。结果:①腋窝引流液中C-met的阳性表达率为84.38%,高于常规病理检查腋窝淋巴结转移癌的阳性率,C-met的阳性表达率与腋窝淋巴结转移的个数呈正相关;②腋窝引流液中C-met的阳性表达率与肿瘤的大小呈正相关;③ER和PR的阴性与C-met表达呈负相关趋势。结论:应用RT-PCR检测乳腺癌患者常规术后腋窝引流液中的C-metmRNA表达阳性提示病人患侧胸壁淋巴管内存在肿瘤细胞微转移,预示肿瘤有复发和远处转移可能以及病人的总生存期的缩短。其阳性表达率与肿瘤的大小及分期、淋巴结转移的个数呈正相关。与常规病理检查腋窝淋巴结肿瘤转移相比,能更早地检测出肿瘤细胞在胸壁淋巴管中的转移,而且具有更高的准确性。

BACKGROUND&AIM: To study the significance of C-met mRNA in axillary drainage after operations for breast cancer. MATERIAL AND METHODS: RT-PCR assay was used to examine the expression of C-met mRNA and human glyceraldehydes-3-phosphate dehydrogenase(hGAPDH)in axillary drainage after operations in32cases of breast cancer,The relationship between the expression of C-met and the tumor size and the numbers of lymph nodes metastasis and the Estrogen receptor(ER)and Progesterone receptor(PR)status was analyzed. RESULTS: ①The overall positive expression rate of C-met in axillary lymphatic drainage was84.38%,which was higher than that in routine pathological method of the axillary lymph nodes to detect micrometastasis(P<0.05),and the positive cases of C-met expression were correlated with the numbers of metastatic lymph nodes.②Positive cases for C-met expression were correlated with the tumor size(P<0.01).③C-met negative cases showed the tendency of negative correlations with ER and PR negative cases. CONCLUSION: Detection of C-met mRNA in axillary drainage after operation for breast cancer using RT-PCR,the positive cases suggest existence of micrometastasis of cancer cells in the lymphatic of chest wall of breast cancer patients and there was a potential of recurrence and metastasis.The study suggests that it could be earlier and more accurate to detect micrometastasis using RT-PCR of the axillary lymphatic drainage for C-met expression in the axillary fluids than routine pathological method on the axillary lymph nodes.