CA15-3 RT-PCR检测乳腺癌腋窝淋巴结微小转移

Detection of Lymph Node Micrometastases with CA15-3 RT-PCR in Breast Cancers

目的:探讨检测乳腺癌淋巴结微小转移的新方法。方法:以RT-PCR检测CA15-3mRNA中一段基因。总RNA是从乳腺癌细胞系MCF-7及原发性乳腺癌腋窝淋巴结提取。结果:CA15-3mRNA可从MCF-7细胞和19例初发乳腺肿瘤患者中检测到,从良性乳腺疾病中取材的淋巴结不能检测到。通过倍比稀释发现CA15-3RT-PCR是一种很敏感的方法,可以检测到1/106个转移的肿瘤细胞。检测的敏感性同免疫组化作了比较,19例患者取材的65个腋窝淋巴结,分别用RT-PCR和免疫组化作检测。在7个淋巴结中的肿瘤细胞微小转移只能通过CA15-3RT-PCR方法检测到。CA15-3RT-PCR方法发现2例HE染色和免疫组化染色不能发现的淋巴结有转移的肿瘤患者。结论:CA15-3RT-PCR是比免疫组化和HE染色更敏感的方法,可以避免已有淋巴结微小转移的患者被漏诊。

Objective:To evaluate the hypothesis that a multigene reverse transcriptase-polymerase chain reaction(RT-PCR)panel provides a more sensitive method to detect axillary lymph node metastases than routine pathological examination.Methods:Fifteen consecutive breast cancer patients were studied with7normal control patients.RT-PCR analysis was per-formed with primer specific for CA15-3and beta-actin using ethidium bromide gel electrophore-sis.RT-PCR positive /pathologic negative axillary lymph nodes were reevaluated using step sec-tioning and immunohistochemical staining.Results:Forty-six patients had negative axillary lymph node,of which7(15%)were positive by RT-PCR test.The sensitivity of CA15-3RT-PCR was1cancer cell/10cells.Conclusion:CA15-3RT-PCR analysis appears to be a readily available and highly sensitive method for detection of axillary lymph node micrometastases.