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1、維普資訊http://www.cqvip.com·62中華腫瘤雜志2生!筮箜鲞箜塑』．臨床研究．檢測肺癌患者外周血和骨髓微轉(zhuǎn)移的臨床意義周清華宮友陵覃揚孫芝琳孫澤芳劉倫旭李潞朱文【摘要】目的探討檢測肺癌患者外周血和骨髓微轉(zhuǎn)移的特異性、敏感性及臨床意義。方法應(yīng)用巢式RT-PCR技術(shù)，檢測59例肺癌患者、11例肺部良性病變患者和20例健康人外周血、骨髓中CK19mRNA表達(dá)。結(jié)果巢式RT-PCR檢測技術(shù)的敏感性達(dá)到10-6。59例肺癌患者中，加例檢測出外周血微轉(zhuǎn)移，l3例檢測出骨髓微轉(zhuǎn)移，其陽性檢出率分別為33．9％(20／59)和22
2、．0％(13／59)，二者有顯著正相關(guān)(P<0．05)。肺癌患者外周血和骨髓微轉(zhuǎn)移與肺癌組織學(xué)類型、細(xì)胞分化程度及P-TNM分期均存在密切關(guān)系(P<0．05或P<0．01)。肺良性病變患者、健康人外周血和骨髓中均未檢測出CK19mRNA表達(dá)。結(jié)論肺癌患者外周血和骨髓中均存在用常規(guī)方法檢測不出的微轉(zhuǎn)移；應(yīng)用巢式RT-PCR技術(shù)檢測肺癌患者外周血和骨髓中CK19mRNA表達(dá)，對肺癌微轉(zhuǎn)移的分子診斷具有重要的理論意義和臨床應(yīng)用前景。【主題詞】肺腫瘤；癌，非小細(xì)胞肺；腫瘤轉(zhuǎn)移；聚合酶鏈反應(yīng)Valueofa~noangmicrometasta
3、sisbynestedR11-PCRintheperipheralbloodandbonemaI1innon-smallcelllungcancerpatientszHOUQtf曾hun，GONGYou-ling，QINYang，sUNZhi-lin，sUNZe-fang，，JH，13，ZHUn、Laboratoryo廠Z枷CancerMo~cularBiology，CancerCenterandCancerlmtitutetChinaHospit，SwhuanUniversity，Chengdu610041，China【Abstr
4、act】ObjectiveToevaluatethespecificity，sensitivityandtheirclinicalsignificanceofdetectingCK19mRNAexpressionbvnestedRrr_pCRformoleculardiagnosisofmicmmetastasisintheperipheralbloodandbonerflalTowofpatientswithnon-smallcellungcancer．MethodsCK19ⅡlRNAexpressionWaSdetectedby
5、nestedRT—PCRinperipheralbloodandboneIIIalTOWsamplesfrom59lungcancerpatients，withsamplesofllt-e印pulmonarylesionpatientsand20heal山y(tǒng)adultsascontro1．ResultsThesensitivityofnestedr-PCRWaSl0_。。．rhepositiveratesofmicrometastasiswere33．89％(20／59)inperipheralbloodand22．03％(13／5
6、9)inbonemarrow，withahighlypositivecorrelationexistingbetweenthetwogroups(P<0．05)．Ikmicrometastasisiflperipheralbloodandbonemal'l~WwaScloselycorrelatedwiththepathologiealelassifcationandcelldiferentiation(P<0．05)andp-TNMstage(P<0．01)．NoCK19mRNAexpressionWaSfoundinthesam
7、plesfrompatientswb-epulmonarylesionorhealthyadultvolunteers．ConclusionnIeperipheralbloodandbonemanowfrompatientswithnon—smallcellungcancerpossessesmierometastasisthatCannotbedetectedbycommonmethocls．NestedRT-PCRtechniqueshowsfavorablespecificityandsensitivityindetectin
8、gtheconditionwithdefiniteclinicalprospects．【SubjectWOldS】IamgneoplaSms；Carcinoma，non-smallcalllung；Neoplasmmetastasis
