Detection Of Micrometastasis In Peripheral Blood Of Non-small Cell Lung Cancer Patients By Nested RT-PCR And Its Clinical Significance

Objective: To investigate the clinical significance of circulating cytokeratin-19 (CK-19) mRNA detection in NSCLC patients.Methods: 1. Nested reverse transcription-polymerase chain reaction (nested RT-PCR) was used to detect the expression of CK19mRNA in peripheral blood samples of 110 NSCLC patients, 19 benign lung disease patients and 22 healthy volunteers. Trend chi-square test was employed to discuss the correlation of CK19mRNA expression and clinical stage. 2. All the NSCLC patients were followed up. The relationships between CK19mRNA expression in peripheral blood and disease-free survival rates were investigated. 3. CK19mRNA expression in peripheral blood of 4 cases NSCLC patients, normalized by the expression level of SPC-A1 lung cancer cell stain, were detected before and after chemotherapy in order to explore the feasibility of using CK-19mRNA as an marker to early evaluate the chemotherapy response.Results: 1. The positive detection rate of CK-19 mRNA in the peripheral blood of NSCLC patients was 56.4% (62/110) which was significantly higher than 5.26% of benign lung disease patients (x~2=16.932, P<0.001) .None of the 22 healthy volunteers was found to have the the expression of CK19mRNA. The positive detection rate of CK-19mRNA for NSCLC patients increased with a pattern depending on the clinical stage (x~2=4.768, p=0.029). 3. In 45 cases of operable patients, the 1-year and 2-year disease-free survival rates of 65% and 34.3% in the CK-19 mRNA positive group were significantly lower than that of 76% and 64% in the negative group , and median DFS was 18 months and 27 months in CK19mRNA positive and negative group, respectively. The difference between the two groups is significant (Lon Rank value =...