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目的:应用乳腺癌特异性标志物乳腺珠蛋白(hMAM)检测腋淋巴结阴性乳腺癌(axillarylymphnodeneg鄄ativebreastcancer,ALNNBC)外周血中微转移,并探讨其与临床病理因素的关系。方法:采用巢式RT-PCR方法,分别检测62例ALNNBC、6例乳腺良性疾患和6例健康成人女性外周血中hMAMmRNA的表达,并以MDA-MB415细胞为阳性参考检测该方法的灵敏度。结果:ALNNBC外周血hMAM表达阳性率为32.3%(20/62),乳腺良性疾患组和健康成人女性组全部阴性表达;该方法检测外周血微转移的灵敏度达1/106;C-erbB2基因阳性表达者微转移发生率高(P<0.01),月经状态、肿瘤大小、组织学类型、ER状态、p53表达等与微转移无关(P>0.05);复发转移组较无瘤生存组外周血中微转移率高(P<0.01)。结论:hMAM可作为乳腺癌外周血微转移的标志物;ALNNBC微转移与C-erbB2密切相关;外周血微转移可以作为ALNNBC预后指标。
OBJECTIVE: To detect micrometastasis in peripheral blood of axillary lymph node-negative breast cancer (ALNNBC) with breast cancer-specific marker mammoglobin (hMAM) and to explore its relationship with clinicopathological factors. Methods: The expression of hMAM mRNA in peripheral blood of 62 cases of ALNNBC, 6 cases of benign breast diseases and 6 cases of healthy adults were detected by nested RT-PCR. The sensitivity of this method was tested by positive staining with MDA-MB415. Results: The positive expression rate of hMAM in peripheral blood of ALNNBC was 32.3% (20/62), all of them were negative in benign breast disease group and healthy adult female group. The sensitivity of this method for detection of peripheral blood micrometastasis was 1/106. The positive rate of C-erbB2 gene The incidence of micrometastasis was significantly higher in patients with recurrence and metastasis (P <0.01), and no correlation with micrometastasis (P> 0.05), the status of menstruation, tumor size, histological type, ER status and p53 expression Micro-transfer rate was high (P <0.01). Conclusion: hMAM can be used as a marker of peripheral blood micrometastasis in breast cancer; micrometastasis of ALNNBC is closely related to C-erbB2; peripheral blood micrometastasis can be used as a prognostic indicator of ALNNBC.