细胞角蛋白19mRNA在口腔鳞状细胞癌中表达的研究

Study on the expression of cytokeratin 19 mRNA in oral squamous cell carcinoma

目的探讨口腔鳞状细胞癌(OSCC)患者癌组织中细胞角蛋白(CK)19mRNA的变化和其发生的可能机制以及CK19mRNA检测的临床应用价值。方法收集未接受过放疗和化疗的20例OSCC患者的手术标本(包括癌组织20块、癌旁组织20块和颈清扫的淋巴结43枚),采用荧光定量聚合酶链式反应(FQ-PCR)法检测组织内CK19mRNA的表达,比较CK19mRNA在上述组织中的相对表达量。结果CK19mRNA在OSCC癌组织内表达比其在正常口腔黏膜内表达高1.85倍,比其在癌旁组织内表达高1.66倍。9例患者颈清扫淋巴结内CK19mRNA表达阳性,阳性率为45%(9/20),而9例患者的22枚淋巴结中CK19mRNA表达阳性率是81.8%(18/22),占20例患者43枚淋巴结的41.9%(18/43)。淋巴结CK19mRNA阳性患者的癌组织与癌旁组织和正常口腔黏膜的表达量比CK19mRNA阴性患者低。结论CK19mRNA在OSCC癌组织中的表达高于其在癌旁组织和正常口腔黏膜内的表达,可能是由于癌组织中CK19的合成明显增加所致。淋巴结中CK19mRNA的表达可以作为检测OSCC淋巴结微转移的指标之一,运用FQ-PCR法检测淋巴结中CK19mRNA的表达来检测OSCC的淋巴结微转移比普通病理法检测更灵敏。

Objective To elucidate the possible mechanism of oral carcinogenesis and to explore the value of clinical application of the detection of cytokeratin（CK） 19 for oral squamous cell carcinoma（OSCC） patients. Methods The cancerous tissues, para-cancerous tissues and excised lymph nodes were collected from 20 operated patients with OSCC. The patients didn＇t receive radiotherapy and chemotherapy before hospitalization. The relative expression of CK19 mRNA in those tissues was detected by fluorescent quantitative polymerase chain reaction （FQ-PCR）. Results The expression of CK19 mRNA in the cancerous tissues was 1.85 and 1.66 times higher than that in normal oral mucosa and in para-cancerous tissues, respectively. The expression of CK19 mRNA in lymph nodes from 9 patients with OSCC was positive and the positive rate was 45% （9/20）. The positive rate of CK19 mRNA in all lymph nodes from 9 patients with OSCC was 81.8% （18/22）, and the positive rate of CK19 mRNA in all lymph nodes from 20 patients with OSCC was 41.9%（18/43）. CK19 mRNA level in the cancerous tissues relative to para-cancerous tissues and normal oral mucosa of the patients whose CK19 mRNA expression was positive was lower than that of the patients whose CK19 mRNA expression was negative in lymph nodes, respectively. Conclusion The possible reason that the expression of CK19 mRNA in the cancerous tissues was higher than that in para-cancerous tissues and normal oral mucosa was that the CK19 synthesis in cancerous tissues increased obviously. The detection of CK19 mRNA in lymph nodes was regarded probably as one of the markers for detecting OSCC micrometastasis in lymph nodes. The detection of CK19 mRNA in lymph nodes by FQ-PCR was more sensitive than hematoxylin-eosin staining in diagnosing OSCC micrometastasis.