宫颈癌根治术对外周血CK19 mRNA和SCCAg mRNA表达影响的临床研究

The influence of radical hysterectomy in the expression of CK19 mRNA and SCCAg mRNA of cervical cancer

目的:探讨宫颈癌根治术对外周血细胞角蛋白19(CK19)和鳞状细胞癌相关抗原(SCCAg)表达的影响。方法:采用实时逆转录聚合酶链式反应(qRT-PCR)技术从外周血总RNA中扩增CK19和SCC基因,检测并对比其在实验组(ⅠA2~ⅡA1期宫颈癌患者30例)、阳性对照组(ⅡB~ⅢB期宫颈癌患者30例)和阴性对照组(子宫肌瘤患者15例、健康体检者15例)患者术前的表达水平;同时检测并对比实验组患者行宫颈癌根治术前、术后24h及术后30天的CK19和SCCAg表达水平。结果:(1)实验组术前CK19mRNA的表达水平为0.79±0.21,阳性检出率为30%(9/30),SCCAg mRNA表达水平为0.69±0.11,阳性检出率为20%(6/30);实验组术前CK19 mRNA、SCCAg mRNA的表达水平和阳性率均显著高于阴性对照组,但低于阳性对照组,均有显著差异(P<0.01);(2)宫颈癌根治术前CK19 mRNA、SCCAg mRNA的阳性率和表达水平均显著低于术后24h(P<0.05),高于术后30天,但无显著差异(P>0.05)。宫颈癌根治术前CK19 mRNA及SCCAg mRNA阳性检出率与术后病理的高危因素密切相关(P<0.05)。结论:宫颈癌根治术有增加患者外周血循环肿瘤细胞水平的趋势。早期宫颈癌根治术前后外周血CK19mRNA及SCCAg mRNA表达检测结果能弥补影像学、肿瘤标记物等检查的不足,为术后辅助治疗方案选择、判定预后提供依据。

Objective:To investigate the influence of radical hysterectomy in the expression of CK19 and SCCAg of cervical cancer.Methods:The total RNA was extracted from peripheral blood,and then CK19 and SCCAg was applied by quantitative reverse transcriptase-polylmerase chain reaction PCR(RT-PCR).Detecte and compare the expression of CK19mRNA and SCCAgmRNA in the experimental group(30 patients with cervical cancerⅠA2~ ⅡA),positive control group(15 patients with cervical cancerⅡB~ ⅢB),negative control group(15 patients with uterine fibroids and 15 healthy cases) before surgery.Detect and compare the expression of CK19 mRNA and SCCAg mRNA in the experimental group 24h before,24 hours after and 30 days after the radical hysterectomy seperately.Results:(1) In experimental group,the preoperative CK19 mRNA expression level was 0.79 ± 0.21,the positive rate was 30%(9 / 30),preoperative SCCAg mRNA expression level was 0.69 ± 0.11,the positive rate of 20%(6/30).The preoperative expression levels of both were higher than those in the negative control group,but lower than those in the positive control group.All have statistically significant(P < 0.01).(2) The positive rates of CK19 mRNA and SCCAg mRNA before surgery in experimental group were less than that in 24 hours after surgery,whose difference was statistically significant(P < 0.05),but higher than that in 30 days after surgery,whose difference was not statistically significant(P > 0.05).It was same to CK19 mRNA and SCCAg mRNA expression levels.The positive rates of CK19mRNA and SCCAgmRNA before operation were correlated with postoperative pathologic risk factors(P < 0.05).Conclusions:The radical hysterectomy in early cervical cancer may increase the level of circulating tumor cells.Detection of peripheral blood CK19 mRNA and SCCAg mRNA expression before and after receiving radical hysterectomy in patients with early cervical cancer could make up for the disadvantage of other methods such as the image,tumor marker detection and provide the basis for choosing a proper adjuvant post-operation therapy and estimating the prognosis.