NSCLC外周血、区域淋巴结微转移检测对术前分期的临床价值

Clinical value in staging of detecting micrometastasis in the peripheral blood and regional lymph nodes of pre-operative patients with non-small cell lung cancer

目的:探讨检测非小细胞肺癌(NSCLC)患者术前区域淋巴结及外周血LunxmRNA表达对肺癌术前分期的临床价值。方法:采用荧光定量RT-PCR技术,检测43例初治NSCLC患者、20例肺部良性病变患者的外周血和术前经TBNA所获得的区域淋巴结,及10例健康人外周血的LunxmRNA表达。结果:NSCLC患者外周血LunxmRNA表达阳性率为51.16%(22/43);术前获得的64枚区域淋巴结LunxmRNA阳性率为93.75%(60/64),与病理阳性率70.31%(45/64)比较有显著差异;区域淋巴结Lunx的检出率要比常规病理和外周血Lunx的检出率高(P<0.01)。肺癌患者外周血微转移与细胞分化程度、术前临床分期均存在密切关系(P<0.05)。而对照组的所有标本只有1枚淋巴结检出LunxmRNA。结论:检测外周血和术前区域淋巴结LunxmRNA表达可作为诊断早期NSCLC患者微转移的参考指标,有助于完善病理C-TNM分期并指导临床综合治疗。

Objective ： To study the clinical value in accurate staging of expressions of Lunx mRNA in the periph- eral blood and regional lymph nodes of pre- operative patients with nonsmall cell lung cancer（NSCLC） for diagno- sing micrometastasis. Methods：Fluorescent quantitative reverse transcription PCR （FQ - RT - PCR） was used to detect the expression of Lunx mRNA in peripheral blood and regional lymph nodes from 43 patients with NSCLC. Periph- eral blood and regional lymph nodes from 20 patients with pulmonary benign diseases and peripheral blood from 10 healthy volunteers were served as controls. Resullks：The positive expression of Lunx mRNA was 51.16% （22/43）in peripheral blood of patients with NSCLC 45 （70.31%）of which showed histologically metastasis with HE staining, while 60（93.75% ） were Lunx mRNA positive by FQ - RT - PCR among 64 regional lymph nodes from 43 NSCLC patients and there was a significant difference. The Lunx mRNA＇s positve rate of regional lymph nodes was higher than the peripheral blood and the histopathological examinationg （P 〈 0.01 ）. The micrometastasis in peripheral blood was closely related with the cell differentiation and pre - operative C - TNM staging （ P 〈 0.05 ）. In control samples, only one regional lymph nodes was observed the Lunx mRNA expression. Conclusion：The expression of Lunx mRNA in peripheral blood and pre - operative regional lymph nodes can be used as diagnostic biomarkers of micrometastasis in patients with NSCLC.