非小细胞肺癌术前转移相关基因联合检测的临床意义

Clinical significance of pre-operative combined detection of metastasis-relative genes in non-small cell lung cancer

目的探讨非小细胞肺癌术前转移相关基因联合检测的临床意义。方法采用RT-PCR法联合检测46例病人术前外周血淋巴细胞及术后切除组织标本中转移相关基因CD44v6和nm23H1mRNA的表达,分析其与淋巴结转移的关系;建立ROC曲线确定术前淋巴结转移预报的界定值。结果淋巴细胞及组织标本中CD44v6mRNA的相对含量在有淋巴结转移组高于无淋巴结转移组(P<0.05);nm23H1mRNA的相对含量在有淋巴结转移组低于无淋巴结转移组(P<0.05)。预报转移的界定值确定为CD44v6≥1.20、nm23H1≤0.80。结论用术前外周血淋巴细胞中mRNA相对含量CD44v6≥1.20、nm23H1≤0.80作为界定值进行串联试验来预报NSCLC淋巴结转移具有较高的灵敏度、特异度,对于无创性术前预报NSCLC淋巴结转移具有一定价值,可能为临床病理诊断淋巴结转移提供有意义的补充。

Objective The purpose of this study was to investigate the clinical significance of pre-operative combined detection of metastasis-relative genes in non-small cell lung cancer. Methods Peripheral blood lymphocyte specimens from 46 patients before operation and fresh tissue specimens after operation were examined by RT-PCR analysis of CD44v6 and nm23H1 mRNA. The results were compared to the pathological diagnosis of lymph node metastases. ROC curve was used to determine the cut-off value of pre-operative metastases prediction. Results The relative an：ount of CD44v6 mRNA was higher （P〈 0.05） while nm23H1 mRNA was lower （ P 〈 0.05） in group with lymph node metastases. Relative amount of CD44v6 mRNA ≥ 1.20 and nm23H1 mRNA ≤ 0.80 was established as cut-off to forecast the lymph node metastases in NSCLE. The sensitivity and specificity were acceptable. The combined detection of CD44v6 and nm23H1 mRNA in serial test have an advantage in specificity and accuracy over any single gene. Conclusion Relative amount of CD44v6 mRNA ≥ 1.20 and nm23H1 mRNA ≤0.80 as cut-off to forecast the lymph node metastases in NSCLC showed acceptable sensitivity and specificity. Result of the serial test was useful in pie-operative forecasting of NSCLC lymph node metsstases and may be a helpful supplement to the pathological diagnosis of NSCLC lymph node metastases.