早期宫颈癌患者外周血CK19和CK20mRNA的检测及临床意义

Detection of CK19 mRNA and CK20 mRNA in peripheral blood cells of patients with early cervicalcancer and its clinical significance

目的:研究早期宫颈癌患者外周血中CK19、CK20 mRNA的表达及其临床意义.方法:采用RT-PCR法术前检测250例ⅠA～ⅡA期宫颈癌患者和50例妇科良性肿瘤患者及18名健康自愿者外周血中CK19、CK20 mRNA的表达,并分析其与临床病理因素的关系.结果:250例早期宫颈癌患者外周血中CK19、CK20 mRNA的阳性表达率分别为36%和24%,而在妇科良性肿瘤中分别为3.0%和0%,18例健康自愿者无一例表达CK19、CK20 mRNA阳性(P<0.01);CK19、CK20 mRNA的单独阳性表达率除与脉管瘤栓显著相关外(P<0.01),与宫颈癌的预后因素如分期、分化、组织类型、淋巴结转移、肿瘤大小均无关(P>0.05),而CK19、CK20mRNA双阳性表达与淋巴结转移和脉管浸润及近期盆腔外的转移显著相关(P<0.01).结论:外周血中CK19、CK20 mRNA的表达可以作为检测早期宫颈癌微转移的生物学指标,但对预后的意义有待于进一步研究.

Purpose：To study the expression of CK19 and CK20mRNA in peripheral blood patients with FRCO Stage ⅠA to ⅡA cervical carcinoma and to investigate its clinical signifieance.Methods：Using the reverse transeription polymerase chain reaction（RT-PCR）,CK19 and CK20mRNA expression was examined in peripheral blood from 250 patients with early cervical careinoma before operation,50 Patients with benign gynecologieal tumors and 18 healthy volunteers.In 250 patients,pussible correlations betweenclinical pathological factors were analyzed.Results：The positive expression rates of CK19 and CK20mRNA were 36% and 24% in 250 cervical careinomas respectively,in comparison with 3.0% and 0% with benign gynecological tumors and all subjects in healthy volunteers were negative;The expression of CK19 and CK20 mRNA were significantly correlated with lymph vascular space involvement.but was not associated with prognostie factors ineluding slge,differentiation,pathologiral types,lymph node metastasis,bully tumor size,In patients with CK19 mARNA（＋）/CK20 mRNA（＋）,the rate of lymph node metastasis and vascular space involvement and recurrence outside the pelvis was significantly higher than that of patients with CK1R mNA9（-）/CK20 mRNA（-）（p〈0.01）.Conclusions：The detection of CK19 and CK20 mRNA in peripheral blood with RT-PCR may be a potential hiomarker for detecting micromelastasis in early cervical carcinoma,but the predictive value of this early detection warrants further studies.