乳腺癌外周血微转移的检测及临床意义

Detection and clinical significance of peripheral blood micrometastasis in patients with breast cancer

目的:研究人乳腺珠蛋白hMAMmRNA表达与乳腺癌临床生物学预测指标的关系,探讨其作为乳腺癌微转移标志物的可能性。方法:应用巢式逆转录聚合酶链反应(nested-RT-PCR)技术对乳腺癌、乳腺良性肿瘤患者及健康志愿者外周血hMAM-mRNA的表达进行检测。结果:乳腺癌患者外周血中hMAM-mRNA阳性表达率为50·75%(34/67),而hMAM-mRNA在健康人外周血中无表达;16例乳腺良性疾病患者中仅1例阳性表达,乳腺癌hMAM-mRNA的阳性表达率与乳腺良性肿瘤患者及健康人比较差异有统计学意义,χ2=24·1735,P=0·000。乳腺癌患者临床分期为Ⅰ、Ⅱ、Ⅲ和Ⅳ期者,其外周血hMAM-mRNA阳性表达率分别为25·00%(2/8)、45·80%(11/24)、43·75%(7/16)和73·70%(14/19),Ⅳ期乳腺癌hMAM-mRNA阳性表达率明显高于Ⅰ、Ⅱ、Ⅲ期,χ2=5·5268,P=0·0187。结论:hMAM-mRNA是一个有价值的检测乳腺癌微转移的标志物,对指导临床治疗和评估预后可能具有重要意义。

OBJECTIVE： To study the relationship between expression of human mammoglobin （hMAM） mRNA and biological characteristics of breast cancer and evaluate its clinical significance. METHODS： Expression of hMAM mRNA was detected in peripheral blood from patients with breast cancer and breast benign lesions, and healthy volunteers by the nested reverse transcriptase polymerase chain reaction （nested-RT-PCR）. RESULTS： hMAM mRNA was found in 34 of 67 （50.75%） samples of peripheral blood from patients with breast cancer, and no hMAM mRNA was found in peripheral blood of healthy volunteers, but in only one of the 16 patients with breast benign lesions,X^2=24.173 5, P=0.000. In breast cancer patients, the positive rate of hMAM mRNA was 25.00% （2/8） in stage Ⅰ , 45.80% （11/24） in stageⅡ , 43.75% （7/16） in stage Ⅲ, 73.70% （14/19） in stage Ⅳ, respectively. The expression of hMAM mRNA in peripheral blood of breast cancer patients with Ⅳ stage was significantly higher than those in patients with stage Ⅰ, Ⅱ and Ⅲ, X^2 = 5.526 8, P = 0.018 7, CONCLUSION： hMAM mRNA may be a biological marker of micrometastasis for breast cancer and it can provide important information for estimated prognosis and guiding clinical therapy of breast cancer.