荧光定量反转录-聚合酶链反应检测鼻咽癌患者外周血肿瘤细胞微转移的研究

Fluorescent quantitative reverse transcriptase polymerase chain reaction detection of micrometastasis in peripheral blood of patients with nasopharyngeal carcinoma

目的探讨荧光定量反转录聚合酶链反应(FQ-RT-PCR)检测外周血CK14mRNA、表皮生长因子受体(EGFR)mRNA的表达在鼻咽癌患者外周血肿瘤细胞微转移诊断中的价值。方法采用FQ-RT-PCR方法检测87例入组鼻咽癌患者外周血CK14mRNA、EGFRmRNA的表达,并分析其与肿瘤TNM分期、临床分期、组织分化程度的关系。结果 87例鼻咽癌患者外周血中,CK14mRNA、EGFRmRNA阳性表达率分别为64.4%(56/87)、58.6%(51/87),两者联合检测的阳性表达率为71.3%(62/87);CK14mRNA、EGFRmRNA的表达水平与T分期、N分期、临床分期、组织分化程度有关(P<0.05),分期越晚,外周血中CK14mRNA、EGFRmRNA的表达水平越高,低分化鳞癌患者外周血中CK14mRNA、EGFRmRNA的表达水平高于高中分化鳞癌患者。结论 FQ-RT-PCR方法检测鼻咽癌患者外周血CK14mRNA、EGFRmRNA的表达,能够较准确反映外周血肿瘤细胞微转移的情况,在诊断鼻咽癌患者外周血肿瘤细胞微转移方面有一定的可行性;鼻咽癌患者外周血肿瘤细胞微转移与肿瘤的恶性程度和病情进展有关。

Objective To explore the expression of CK14 mRNA and epidermal growth factor receptor （EGFR） mRNA in peripheral blood of patients with nasopharyngeal carcinoma （NPC） and to evaluate its value for diagnosis of micrometastasis. Methods The expression of CK14 mRNA and EGFR mRNA in the peripheral blood was detected by fluorescent quantitative reverse transcriptase polymerase chain reaction （FQ-RT-PCR）. The correlation between the peripheral blood micrometastasis and tumor TNM stage, clinical stage, degree of histologic differentiation of tumor was analyzed. Results The rate of positive expression of CK14 mRNA and EGFR mRNA in peripheral blood of 87 patients with NPC was 64.4% （56/87）and 58.6% （51/87）respectively; the combined assay produced a value of 71.3% （62/87）. The later the stage of carcinoma, the higher the level of expression. The level of expression in poorly differentiated squamous call carcinoma was higher than that in well differentiated squamous cell carcinoma. Conclusions Detecting the expression of CK14 mRNA and EGFR mRNA in peripheral blood of patients with NPC by FQ-RT-RCR could accurately reflect the situation of peripheral blood micrometastasis. There was correlation between peripheral blood micrometastasis and malignant degree and the disease progression.