2017 年第 1 期 第 15 卷

非小细胞肺癌患者外周血CD44V6mRNA表达与微转移的相关性研究

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关键词：CD44V6mRNA非小细胞肺癌微转移联合检测

• 摘要：
• 【摘要】目的:探讨CD44V6mRNA表达与NSCLC外周血微转移的关系及临床意义，及其与CK19mRNA在外周血中联合检测的临床意义。方法:应用免疫组化S-P法检测56例NSCLC癌组织中CD44V6mRNA的表达情况，应用逆转录聚合酶链反应（RT-PCR）技术检测外周血中其与CK19mRNA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:1.CD44V6在NSCLC组织中表达显著高于良性病变正常肺组织(P＜0.001)，其表达率在各病理分期间(P=0.005)、有无淋巴结转移组间(P=0.024)的差异具有统计学意义，而在各病理类型间无显著差异(P=0.125)。2.NSCLC患者外周血中CD44V6mRNA阳性表达率显著高于对照组(P＜0.05)，其阳性表达率在各病理分期间（P=0.016）、有无淋巴结转移组间(P=0.02) 的差异具有统计学意义。3. CD44V6基因在NSCLC组织中表达与外周血中表达正相关(rs=0.332,P=0.014)；NSCLC外周血中CD44V6mRNA与CK19mRNA表达成正相关(rs=0.409,P=0.002)；CD44V6mRNA与CK19mRNA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CD44V6mRNA的高表达与其侵袭转移有关，CD44V6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；CD44V6mRNA与CK19mRNA联合检测可提高NSCLC血行微转移诊断的敏感性。
• 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.