肺癌患者外周血中Lunx mRNA的检测及其临床意义

Clinical Significance of Lunx mRNA Expression in Peripheral Blood of Lung Cancer Patients

目的评价肺癌患者外周血中Lunx mRNA表达用于诊断肺癌微转移的特异性和敏感性,探讨肺癌转移的早期诊断方法。方法2004年3月～2005年2月,以Lunx mRNA为肿瘤标记物,采用逆转录-聚合酶链反应(reverse transcription-polym erase chain reaction,RT-PCR)技术,检测60例～期行手术治疗的肺癌患者(肺癌组)外周血Lunx mRNA的表达,并以行手术治疗的20例肺良性病变患者(肺良性病变组)及10例健康人外周血(健康对照组)作为对照。结合病理类型、临床分期、随访,评价Lunx mRNA作为肺癌微转移肿瘤标记物的临床意义。结果(1)肺癌组患者外周血中Lunx mRNA的阳性表达率为46.7%(28/60),Lunx mRNA在肺良性病变组(0/20)和健康对照组外周血中无表达(0/10);(2)Lunx mRNA在肺癌I期患者中阳性表达率为8.3%(1/12),期患者中为33.3%(5/15),期患者中为66.7%(22/33),期和期患者的Lunx mRNA表达差异无统计学意义,期与期、期患者的Lunx mRNA表达差异有统计学意义(χ2=15.88,P=0.000);(3)在38例腺癌患者中17例Lunx mRNA表达为阳性,在14例鳞癌患者中7例表达为阳性,3例腺鳞癌患者中3例表达为阳性,3例小细胞肺癌患者中1例表达为阳性,1例大细胞肺癌和1例肉瘤样癌患者表达为阴性。不同病理类型的肺癌患者的Lunx mRNA表达差异无统计学意义;(4)截至2005年3月的随访发现,Lunx mRNA表达阳性的28例患者中有9例发生转移,Lunx mRNA表达阴性的32例患者中仅1例发生转移。结论在肺癌患者外周血微转移的检测中,Lunx mRNA表现出较高的敏感性和特异性,有可能成为诊断肺癌外周血微转移较合适的分子标记物。

Objective To evaluate the sensitivity, specificity and clinical significance of Lunx mRNA in surveying micrometastasis by sampling peripheral blood of lung cancer patients, studying the early diagnosis of lung cancer metastasis. Methods From March 2004 to February 2005,Reverse transcription-polymerase chain reaction （RT-PCR） was used to detect Lunx mRNA of peripheral blood of 60 lung cancer patients （lung cancer group）. Peripheral blood of 20 patients with pulmonary benign lesions （pulmonary benign lesions group） and 10 normal healthy volunteers （control group） were used as control. Results （1） In the lung cancer group, Lunx mRNA were expressed positive in 28（46. 7%） patients. All the pulmonary benign lesions group （0/20） and the control group （0/10） were expressed negative. （2） One of the 12 stage I patients with lung cancer （8.3%） was positive for Lunx mRNA, 5 of the 15 stage Ⅱ patients （33.3%） were positive, 22 of the 33 stage Ⅱ patients （66.7%） were positive. Comparing the positive rate of these groups, there was no statistically difference between stage Ⅰ and stage Ⅱ , but the difference between stage 1＋ stage Ⅱ and stage Ⅲ was significant （X^2 = 15. 88, P = 0. 000）. （3） In 38 adenocarcinoma, 17 were positive for Lunx mRNA. In 14 squamous carcinoma, 7 were positive. All the 3 adenosquamous carcinoma expressed positive. 1 of 3 small cell lung cancer was positive, 1 large cell carcinoma and 1 carcinoma sarcomatodes expressed negative. Comparing the positive rate of these groups, there was no statistically difference among them. （4） By follow-up till March 2005, 10 lung cancer patients were found metastasis. Among them, 9 were positive for Lunx mRNA expression, and 1 was negative. Conclusion Lunx mRNA has high sensitivity and specificity in surveying micrometastasis by sampling peripheral blood. It would likely to be an proper gene for the detection of micrometastasis in lung cancer patients.