食管癌患者骨髓CK19 mRNA的表达及其临床意义

CK19mRNA Expression in Bone Marrow of Esophageal Cancer Patients and Its Clinical Significance

目的:肿瘤患者骨髓中发现CK19等上皮成分提示发生微转移,本研究旨在探讨检测食管癌患者骨髓CK19 mRNA的表达及其临床意义。方法:应用RT-PCR技术检测61例食管癌手术患者和15例肺及食管良性病变患者骨髓CK19 mRNA的表达,评价RT-PCR方法的敏感性和特异性,分析食管癌患者骨髓CK19 mRNA的表达与临床病理因素和预后的关系。结果:RT-PCR方法的敏感性为10^(-6),15例肺及食管良性病变患者骨髓中均未检测到CK19 mRNA的表达。61例食管癌患者骨髓中,CK19 mRNA阳性13例,阳性率为21.3%。骨髓CK19 mRNA的表达与患者临床病理因素无关(P>0.05)。骨髓CK19 mRNA阳性的食管癌患者术后转移和死亡风险高于CK19 mRNA阴性的患者,多因素分析结果表明CK19 mRNA是独立的预后预测因子。结论:RT-PCR方法检测食管癌患者骨髓微转移具有良好的敏感性和特异性。CK19 mRNA可作为检测食管癌患者骨髓微转移的分子标志物,是患者术后的一个独立预后预测因子,有助于预测食管癌患者的预后。

Objective： Detection of the expression of specific epithelial markers in the bone marrow impliesthe presence of micrometastases. This study was to investigate the clinical significance of bone marrowmicrometastases （BMM） detected by reverse transcriptase-polymerase chain reaction （RT-PCR） in patientswith esophageal cancer. Methods： Expression of CK19 mRNA in the bone marrow of 61 esophageal cancerpatients and 15 benign pulmonary and esophageal disease patients was assessed via RT-PCR. Sensitivityand specificity of RT-PCR was confirmed, and correlation of CK19 mRNA expression to the clinicopathologicfeatures and prognosis of the 61 esophageal cancer patients was analyzed. Results： The sensitivity ofRT-PCR was 10-6, and no CK19 mRNA was detected in the bone marrow of the 15 benign pulmonary andesophageal disease patients. Of the 61 esophageal cancer patients, 21.3% （13/61） were positive for expressionof CK19 mRNA. CK19 mRNA expression did not correlate with the clinicopathologic features of esophagealcancer （P〉0.05）. Patients with CK19 mRNA-positive bone marrow had earlier recurrence and shorter survivalafter surgery. Multivariate analysis showed that CK19 mRNA was an independent predictor of poor prognosis.Conclusion： RT-PCR is both sensitive and specific in detecting BMM in esophageal cancer paitients.CK19 mRNA can be used as a molecular maker for bone marrow micrometastases in patients with esophagealcancer. Early detection may be helpful for selecting the proper therapy for esophageal cancer patientsand predicting the prognosis.