The Relationship Of Neoadjuvant Chemotherapy And Micrometastasis Of Bone Marrow Of Ⅲ Stage Non-Small Cell Lung Cancer.

Objective: To detect the micrometastases ststus in bone marrow of stage â…¢ non-small cell lung cancer(NSCLC) patients by reverse transcriptase-polymerase chain reaction(RT-PCR).Methods: CEA mRNA expression in bone marrow of rib was detected in 41 patients with NSCLC and 10 patients with pulmonary benign lesions as controls by RT-PCR.Results: The positive rate of CEA mRNA expression was 46.3 % (19/41) in bone marrow of NSCLC patients,and 0% in patients with benign lesions(P=0.005).No correlation was observed between the expression and sex,age, cancer cell differentiation,but there was a significant difference in the positive rate between squomocacinoma and adenocacinoma ,the positive rate was 21.7% (5/23) and 66.7 % (8/12) respectively (P=0.013).Conclusion: RT-PCR amplification of CEA mRNA is a sensitive and specific method to detect bone marrow of rib segments of stage â…¢ NSCLC patients.This method may lead to an early diagnosis and treatment of patients with subclinicalmetastasis in bone marrow .Objective: To investigate the relationship of neoadjuvant chemotherapy and bone marrow micrometastasis of stage â…¢ non-small cell lung cancer(NSCLC).Methods CK19 mRNA expression was detected by RT-PCR in rib marrow sample from 36 patients after neoadjuvant chemotherapy during operation,with sample of 35 patients without neoadjuvant chemotherapy during operation as control, all patients were stage â…¢ NSCLC.Results The positive rates of CK19 mRNA were 22.2% (8/36) and 45.7% (16/35) in the neoadjuvant group and the control group respectively (P=0.026) . There was a negative relationship existing between the expression of CK19 mRNA and the sensitivity of chemotherapy (P=0.026), r_s= - 0.372., Cox's model showed that the sensitivity of chemotherapy and the expression of CK19 mRNA had separate and significant impacts on prognosis in neoadjuvant group.Conclusion: Neoadjuvant chemotherapy could reduce the positive rate of micrometastasis. Detecting the expression of CK19 may lead to an early diagnosis and treatment of patients with subclinical metastasis in bone marrow.