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目的研究早期宫颈癌患者外周血CK19 mRNA检测及其临床意义.方法昆明医科大学第三附属医院妇科30例早期(ⅠA2~ⅡA)宫颈癌患者为实验组,15例子宫肌瘤患者和15例健康志愿者为阴性对照组,15例晚期(ⅡB~ⅢB)宫颈癌患者为阳性对照组.收集外周血样本,qRT-PCR技术检测外周血CK19表达水平的变化,分析其与临床病理参数、预后的相关性.结果实验组外周血中CK19表达水平与阴性对照组、阳性对照组比较,差异有统计学意义(P<0.01);30例宫颈癌患者手术前外周血CK19 mRNA阳性检出率为30%(9/30),与淋巴结转移情况、肌层浸润、术后病理高危因素密切相关(P<0.05),而与患者临床病理因素如年龄、临床分期(FIGO)、肿瘤细胞分化程度、肿瘤直径、病理类型之间均无明显相关性(P>0.05).结论宫颈癌根治术前外周血CK19 mRNA表达水平可作为诊断早期宫颈癌循环肿瘤细胞的标志物,能够弥补影像学、肿瘤标志物等检查不足,可能作为预测复发转移、判断预后的辅助指标,为术后辅助治疗方案选择、判定预后提供依据.
Objective To study the detection of CK19 mRNA in peripheral blood of patients with early stage cervical cancer and its clinical significance.Methods 30 cases of early stage cervical cancer (ⅠA2 ~ ⅡA) in the Third Affiliated Hospital of Kunming Medical University were selected as the experimental group, 15 cases of uterine fibroids and 15 cases of healthy The negative control group and the 15 cases of advanced cervical cancer (ⅡB ~ ⅢB) were positive control group.The peripheral blood samples were collected and the expression of CK19 in peripheral blood was detected by qRT-PCR.The correlation between the expression of CK19 and clinical pathological parameters, prognosis (P <0.01). The positive rate of CK19 mRNA in peripheral blood of 30 patients with cervical cancer before operation was 30 (P0.05) .Conclusion The positive rate of CK19 in the peripheral blood of experimental group is significantly higher than that of negative control group and positive control group % (9/30), which were closely related to the lymph node metastasis, myometrial invasion and postoperative pathological risk factors (P <0.05), but not with the clinicopathological factors such as age, clinical stage (FIGO), tumor cell differentiation, (P> 0.05) .Conclusion The level of CK19 mRNA in peripheral blood of patients with cervical cancer before radical resection can be used as a marker for diagnosis of circulating tumor cells in early stage of cervical cancer, which can make up for the imaging, Tumor markers and other tests, may be used as a prediction of recurrence and metastasis to determine the prognosis of the auxiliary indicators for postoperative adjuvant treatment options to provide the basis for the determination of prognosis.