实时荧光定量RT—PCR检测乳腺癌患者外周血CK19及hMAMmRNA表达的临床意义

Clinical significance of CK19 and hMAM mRNA detection in peripheral blood of breast cancer patients by real-time fluorescent quantitative RT-PCR

目的动态监测乳腺癌患者外周血液中CK19及hMAMmRNA的表达，探讨其临床意义。方法应用实时荧光定量PCR技术，动态检测40例经病理证实的乳腺癌及10例健康对照组外周血液中CK19及hMAM的表达。结果40例乳腺癌循环血液中CK19及hMAM的表达显著高于正常人群。在治疗过程中，乳腺癌患者循环血液中上述指标表达的阳性率呈下降趋势。不同分期乳腺癌在治疗前、中期的表达无显著性差异，但在治疗后期不同分期乳腺癌表达的阳性率差异有统计学意义（CK19：P=0．044；hMAM：P=0．005），对持续阳性的乳腺癌患者，其复发转移率较高，差异有显著性统计学意义（P〈0．001）。结论实时荧光定量PCR技术可检测出各期乳腺癌患者外周血中CK19及hMAM的表达，有较高的敏感性和特异性，在判断乳腺癌预后、监控复发中的应用具有一定的可行性。

Objective To detect the expression of Cytokeratin 19 （CK19） and human mammaglobin （hMAM） mRNA in the peripheral blood of breast cancer patients dynamically and to evaluate its clinical significance. Methods The expression of CK19 and hMAM mRNA was evaluated by real-time fluorescent quantitative reverse transcriptase polymerase chain reaction in the peripheral blood of 40 breast cancer patients and 10 healthy volunteers. Results The expression of CK19 and hMAM in the peripheral blood of 40 breast cancer patients were higher than healthy donors. The positive expression rate of CK19 and hMAM was descending tendency during treatment. The different staging expression rate had no differences between before treatment and during treatment, but after treatment the expression rate had remarkably differences （ CK19 ： P = 0.044 ; hMAM ：P = 0. 005 ）. If the expression of CK19 and hMAM was continual positive, the rate of recurrence and metastasis would be higher （ P 〈 0. 001 ）. Conclusions Real-time fluorescent quantitative RT-PCR may detect the expression of CK19 and hMAM in the peripheral blood of breast cancer patients, and it is a sensitive and specific technique. The results suggest a possible use of this approach for evaluating prognosis, monitoring recurrence.