乳腺癌患者外周血EMA和EGP-2mRNA的表达及其临床意义

Expression of EMA and EGP-2 mRNA in peripheral blood of patients with breast carcinoma and its clinical significance

目的探讨上皮膜抗原(EMA)和表皮糖蛋白基因(EGP-2)在乳腺癌患者外周血中的表达及其与肿瘤微转移的关系。方法采用RT-PCR方法检测53例乳腺癌患者(乳癌组)和24例乳腺良性疾病患者(良性病组)EMA和EGP-2 mRNA在外周血中的表达,并分析其与临床指标之间的关系。结果乳癌组外周血EMA和EGP-2 mRNA的表达率分别为33.96%和28.30%,而在良性病组外周血表达率分别为0和4.17%,差异均有统计学意义(P<0.05)。EMA和EGP-2 mRNA的检出率与腋窝淋巴结转移、TNM分期等临床参数呈正相关;EMA和EGP-2 mRNA联合检测敏感度和准确性在乳腺癌组分别为52.83%和66.23%,相对于EPG-2 mRNA单项检测敏感度及准确性有明显升高,但与EMAmRNA无统计学差异。结论EMA和EGP-2联合检测时准确性明显升高,故两者可作为标志物检测乳腺癌患者外周血微转移,有可能对乳腺癌的疗效和预后判断有意义。

Objeetive To explore the correlation between the expression of EMA and EGP-2 mRNA with tumor micrometastases in peripheral blood of breast cancer （ BC ） . Methods EMA and EGP-2 mRNA were detected by RT-PCR in 53 patients with breast carcinoma, and 24 patients with benign breast lesions. The relationship between EMA and EGP-2 mRNA expression and clinical indexes was analyzed. Results The positive rate of EMA and EGP-2 mRNA expression in the cancer group was 33. 96% and 28. 30% respectively, and no case of positive EMA mRNA expression and only one case of EGP-2 mRNA expression was found in peripheral blood in 24 patients with breast benign lesions （ all P 〈 0. 05 ）. A significant correlation was found between expressions of EMA and EGP-2 mRNA with axillary lymph node metastasis and TNM stage in B C group. The sensitivity and accuracy rate of combined detection of EMA and EGP-2 mRNA was 52. 83% and 66. 23% respectively and was much higher than that of EGP-2 mRNA detection. Conclusions Combined detection of EMA and EGP-2 obviously can improve the accuracy rate in B C. Both of them can be used as tumor markers to detect micrometastases of breast cancer. This may have an impact upon therapeutic recommendations and prognostic judgment in breast cancer patients.