非小细胞肺癌淋巴结中MUC1 mRNA的表达及其临床意义

Expression of Profile of MUC1 mRNA in Lymph Node from Patients with Non-small Cell Lung Carcinoma Detected and Its Clinical Significance

目的探讨非小细胞肺癌(NSCLC)纵隔淋巴结隐匿性转移的基因诊断方法,并评价其对预后的意义。方法应用实时荧光定量RT-PCR技术,检测46例pN0 NSCLC(Ⅰa～Ⅱb期)的188枚纵隔淋巴结标本中的黏蛋白1(MUC1)mRNA的表达情况。对照组为同期经手术治疗的患者,其中阴性对照淋巴结26枚(取自10例肺良性病变),阳性对照标本26个(10例NSCLC的肿瘤标本)。通过χ2检验,比较预后差别。结果阴性对照组均无MUC1 mRNA表达,特异度100%,表达率为0,阳性对照组26个标本中,24个有MUC1 mRNA表达,灵敏度为92.3%,表达率为(94.6±23.4)%。实验组46例患者的12个标本有MUC1 mRNA表达,占11.2%,其TNM分期上调为Ⅲa。MUC1 mRNA表达阴性组3年生存率(88%)高于MUC1 mRNA阳性组(50%),差异有统计学意义(P<0.05)。结论应用实时荧光定量RT-PCR法检测MUC1 mRNA的表达可诊断肺癌纵隔淋巴结隐匿性转移;纵隔淋巴结隐匿性转移可能与pN0肺癌预后不良有关。

Objective To investigate the method of gene diagnosis of occult micrometastasis in the mediastinal lymph node from patients with non small cell lung carcinoma（NSCLC） and evaluate its prognostic significance.Methods By Real-time fluorescent quantitative RT-PCR,mucoid1（MUC1） mRNA levels were detected in 188 mediastinal lymph nodes from 46 pN0（negative lymph nodes） NSCLC patient（stage Ⅰa~Ⅱb）.The Negative control were performed in 26 lymph nodes from 10 pa-tients with benign lung disease,and the positive control were performed in 26 lymph nodes from 10 NSCLC patients.The survival difference between MUC1 mRNA-negative and MUC1 mRNA-positive patients was compared with the χ2 test.Results MUC1 mRNA was not detected in the negative control group（specificity =100%）,while it was detected in 24 lymph nodes from 26 positive control samples（sensitivity=92.3%）.MUC1 mRNA was detected in 12（11.2%） lymph nodes from 46 patients in the ex-periment group for whom TNM stage was upregulated to stage Ⅲa.The 3-year survival rate of patients in the MUC1 mRNA positive group with occult micrometastasis in mediastinal lymph node was lower than that in the patients in MUC1 mRNA negative group（P〈0.05）.Conclusion Occult micrometastasis in the mediastinal lymph node in NSCLC patients can be diagnosed by detecting MUC1 mRNA using real-time fluorescent quantitative RT-PCR.Poor prognosis in some pN0 NSCLC patients may be associ-ated with lymph nodal occult micrometastasis.