Maspin基因在乳腺癌骨髓微小转移检测中的应用

Clinical value of maspin gene on detection of breast cancer micrometastases in bone marrow

目的研究maspin基因在乳腺癌患者骨髓微小转移检测中的应用价值以及其与临床病理因素之间的相关性。方法采用巢式逆转录-聚合酶链反应检测20例良性乳腺疾病和67例乳腺癌患者骨髓中maspin mRNA的表达。结果对照组骨髓中均未检测出maspin mRNA,而在乳腺癌患者骨髓中有30例(44.8%)检测到maspin mRNA。乳腺癌患者骨髓中maspin mRNA表达率随肿块直径增大、临床分期进展而升高,但均无显著性差异;阳性淋巴结个数0～3个组和4个以上组maspin mRNA表达率分别为36.5%和73.3%,差异有显著性(χ2=6.374,P=0.012);0～1期组和2～4期组maspin mRNA表达率分别为22.2%和53.1%,差异有显著性(χ2=5.063,P=0.024);ER阴性组(61.5%)maspin mRNA表达率高于ER阳性组(34.1%)(χ2=4.828,P=0.028);如将患者按复发风险分组,maspinm RNA表达随复发风险性增高而升高,分别为低危组16.7%、中危组40.5%和高危组72.2%(χ2=9.587,P=0.008)。结论Maspin基因用于乳腺癌患者骨髓微小转移检测具有很高的特异性,乳腺癌患者骨髓中maspin mRNA表达与淋巴结转移程度、疾病进展有相关性并可能预示高复发风险。

[Objective ] To study the value of maspin gene on detection of breast cancer micrometastases in bone marrow, and its correlation with clinicopathological factors in breast cancer patients. [Methods] The expression of maspin mRNA was detected by reverse transcription- polymerase chain reaction in bone marrow samples from 20 patients with benign breast disease and 67 patients with breast cancer. [Results] Maspin mRNA was not detected in bone marrow samples from 20 controls, whereas it was detected in 30 of 67 （44.8%） bone marrow samples from breast cancer patients. In breast cancer patients, the expression rates of maspin mRNA in bone marrow seemed to increase with tumor size and clinical stage, but there was no significant difference. Maspin mRNA expression rate was higher in 1〉4 nodes positive group, 73.3%, than in 0-3 nodes positive group, 36.5% （Х^2=6.374, P =0.012）, and was higher in stage 2-4 group, 53.1%, than in stage 0-1 group, 22.2% （Х^2=5.063, P =0.024）. Maspin mRNA expression rate was higher in ER negative group, 61.5%, than in ER positive group, 34.1%（Х^2=4.828, P =0.028）. If the patients were divided in groups by recurrence hazard, the expression rate of maspin mRNA increased with recurrence hazard, 16.7% in low risk group, 40.5% in mediate risk group and 72.2% in high risk group, respectively （Х^2=9.587, P =0.008）. [Conclusions] Maspin gene showed high specificity in detection of bone marrow micrometastases in breast cancer patients. The expression of maspin mRNA in bone marrow showed correlation with extend of lymph nodes metastases and progression of the disease, and might predict high risk of recurrence.