乳腺癌患者外周血hMAMmRNA的检测及其临床意义

THE STUDY OF hMAMmRNA IN PERIPHERAL BLOOD OF PATIENTS WITH BREAST CANCER

目的:研究乳腺癌患者外周血hMAMmRNA,探讨其作为外周血微转移指标对临床的应用价值。方法:采用RT蛳PCR技术检测97例乳腺癌病例外周血hMAMmRNA,观察其个体临床病理参数,并与血清指标CEA、CA153作相关分析。结果:在肿瘤原发灶>2 cm、≤2 cm两组间,外周血hMAMmRNA阳性表达差异有统计学意义(χ2=8.13,P<0.05);淋巴结有无转移两组间差异有统计学意义(P<0.05);有无远处转移两组间差异有统计学意义(P<0.01);对于远处转移的乳腺癌患者,外周血hMAMmRNA、CA153、CEA的检测结果敏感性无统计学意义(P>0.05),但hMAMmRNA与后两者任一联合检测敏感性较单一指标明显提高(P<0.05),并且hMAMmRNA特异性高。结论:外周血hMAMmRNA阳性率可以反映乳腺癌的病期。联合检测外周血hMAMmRNA、CEA、CA153可以提高复发转移指标的敏感性与特异性。

Objective: To study the value of hMAMmRNA in peripheral blood of patients with breast carcinomas using RT- PCR (reverse transcriptase polymerase chain reaction) method, in order to validate its clinical value. Methods: A total of 97 cases patients with breast cancer were invoved in this study. 15 cases of healthy donor were used as control subjects. The hMAMmRNA in peripheral blood of patients with breast carcinomas were detected using RT- PCR, and its relation to clinicopathological features was analysized. Results: There was significant difference in breast cancer of positive hMAMmRNA which is >2cm than that ≤2 cm(P<0.05). There was significant difference in patients with or without lymph node metastasis (P<0.05); There was significant difference in patients with distant metastasis than that of without(P<0.01).There was correlation between the expression of hMAMmRNA and tumor size ,metastasis of lymph node and distant metastasis, respectively(P<0.05).For patients with distant metastasis, there was no statistical difference among hMAMmRNA,CA153,CEA(P>0.05),but combined hMAMmRNA and anyone of last two markers, there was a higher sensitivity than anyone of them(P<0.05), and the specificity of hMAMmRNA was the highest among the three markers. Conclusion: The positive rate of hMAMmRNA in peripheral blood of patients with breast cancer might reflect the extent of illness. The positive hMAMmRNA in peripheral blood might be the marker of high risk on relapse and metastasis of breast cancer. HMAMmRNA in peripheral blood had good specificity. The sensitivity reflected metastasis may be elevated if we check hMAMmRNA using RT-PCR technique combining CEA or CA153 in serum. The clinical utility of hMAMmRNA in peripheral blood might be helpful to detect recurrence and metastasis in patients after surgery.