非小细胞肺癌患者外周血CD_(44)V_6mRNA表达与微转移的相关性研究

Correlation between the expression of CD_(44)V_6mRNA and micrometastasis in peripheral blood of patients with non-small cell lung cancer

目的探讨CD_(44)V_6mRNA表达与非小细胞肺癌(NSCLC)外周血微转移的关系及临床意义,及其与CK19 mRNA在外周血中联合检测的临床意义。方法应用免疫组化SP法检测56例NSCLC癌组织中CD_(44)V_6mRNA的表达情况,应用逆转录聚合酶链反应(RT-PCR)技术检测外周血中CD_(44)V_6mRNA与CK19 mRNA的表达情况。采集20例肺部良性病变患者正常肺组织和外周血作对照。结果 CD_(44)V_6mRNA在NSCLC癌组织中表达明显高于良性病变正常肺组织(P﹤0.001),其阳性表达率在各病理分期间、有无淋巴结转移组间的差异具有统计学意义(P﹤0.05),而在各病理类型间差异无统计学意义(P﹥0.05)。NSCLC患者外周血中CD_(44)V_6mRNA阳性表达率高于对照组(P﹤0.05),其阳性表达率在各病理分期间、有无淋巴结转移间的差异具有统计学意义(P﹤0.05)。CD_(44)V_6mRNA在NSCLC组织中表达与外周血中表达呈正相关,NSCLC外周血中CD_(44)V_6mRNA与CK19mRNA表达呈正相关;CD_(44)V_6mRNA与CK19 mRNA联合检测灵敏度为75.0%,优于单基因检测(P﹤0.05)。结论NSCLC外周血中CD_(44)V_6mRNA的高表达与其侵袭转移有关,CD_(44)V_6mRNA可作为检测NSCLC外周血微转移的分子肿瘤标志物,并有望成为判定NSCLC预后的分子标志物;CD_(44)V_6mRNA与CK19 mRNA联合检测可提高NSCLC血行微转移诊断的敏感度。

OBJECTIVE： To investigate the expression of CD44V6mRNA in tumors and peripheral blood in patients with non-small cell lung cancer（NSCLC） and its clinical significance for micrometastasis. To explore the clinical significance of combined detection of CD44V6mRNA and CK19mRNA in peripheral blood of NSCLC patients. METHODS： The expression of CD44V6mRNA was investigated by immunohistochemistry in cancer tissues and by Reverse Transcriptase-Polymerase Chain Reaction （RT-PCR） in peripheral blood with that of CK19mRNA. RESULTS： The expression of CD44V6 in cancer tissues and peripheral blood of NSCLC were both significantly higher as compared to the control group （P〈0.001,P〈0.05, respectively）. Furthermore, significant difference was noted between the positive rate of CD44V6 in different pathological TNM stages （P=0.005, P=0.016, respectively） and the status of lymph node metastasis （P=0.024, P=0.02, respectively）. No significant difference was noted between the different pathological types （P=0.125, P=0.744, respectively）. The expression of CD44V6 was closely correlated with CK19 in peripheral blood of NSCLC patients （rs=0.409,P=0.002）. Combined detection of CD44V6 and CK19 mRNA in peripheral blood can lead to a higher sensitivity of 75.0% in patients with NSCLC（P〈0.05）. CONCLUSION： The high expression of CD44V6mRNA in peripheral blood is related to the invasion and metastasis of NSCLC. CD44V6 might be a proper molecular marker to detect micrometastasis in the peripheral blood of NSCLC ,which is also expected to be a molecular marker for judging the prognosis of NSCLC; Combined detection of CD44V6mRNA and CK19mRNA can further improve the diagnostic sensitivity of NSCLC.