卵巢癌细胞在血液循环中的微转移

CIRCULATING CELL MICROMETASTASES OF OVARY CANCER

目的 :了解卵巢癌患者除直接侵袭或植入体腔外 ,是否还通过血液循环的渠道而转移。方法 :以角蛋白19(K- 19) - m RNA及癌胚抗原 (CEA) - m RNA两基因的表达为标记物 ;应用巢式—反转录聚合酶链反应 (Nested-RT- PCR)进行扩增 ,经 PAGE后进行观察。结果 :5 1例卵巢癌的骨髓标本中 2 1例 (4 1.18%) K- 19为阳性 ,CEA阳性 4例 (7.84%) ,双阳性 5例 (9.8%) ;K- 19加双项阳性为 2 6例 (5 0 .98%) ,阴性 2 1例 (4 1.2 %)。 2 2例周围血中 K-19阳性 3例 (13.6 3%)、CEA1例 (4 .5 5 %) ,无双阳性 ,阴性 18例 (81.82 %)。经 χ2分析患者骨髓标本结果与正常对照间有显著性差异 (P<0 .0 0 5 ) ,而患者周围血与对照组间则无明显差异 (P>0 .0 5 )。临床分期之早晚及年龄之增长 ,其阳性率有上升趋势。病理型态之恶性程度高者微转移率较恶性程度低者为高。结论 :以 Nested- RT- PCR对 K-19- m RNA表达的检测来判断卵巢癌的微转移是一种很灵敏的方法 ,凡阳性者必须及早采用较长时间化疗 。

Objective:To define if the circulating metastases is another rout beside invasion and planting in body cavity of ovary cancer patients.Methods:Nested reverse transcription polymerase chain reaction (Nested RT PCR) was employed to examine the expression of Keratin 19(K 19) and Carcinoembryonic antigen (CEA) mRNA with bone marrow (BM) aspirates specimens.Results:Of the BM specimen in 51 cases of ovary cancer patients,21(41.18%) K 19 and 4(7.84%) CEA were positive,5(9.8%) were double positive,K 19 plus double positive were 26(50.98%),negative were 21(41.2%).Of the 22 patients′peripheral blood (PB) samples,3 cases (13.63%) K 19 and 1 case (4.55%) CEA were positive,no double positive,and 18 cases (81.82%) were negative.Analysis by statistical method (χ 2) showed significant difference between BM and PB or control samples ( P <0.005),while there was no difference between PB sample and control ( P >0.05).The positive rate increased according to the progressing of clinical stages,ages,as well as the pathological types and malignant degrees.Conclusion:Nested RT PCR express the K 19 mRNA is a sensitive method to detect the micrometastases of ovary cancer.The positive case must have a sufficient and prolonged chemotherapy as early as possible,so as to investigate the effect and to protect from the relapse.