Micrometastasis Of Bone Marrow And Blood And Its Changes After Operation And Chemotherapy In Breast Carcinoma

Objective: Breast carcinoma is one of the commonest malignant tumor in women. Finding out the metastasis early is important for the tumor staging, prognosis judgment and therapeutic method determination in those patients with breast carcinoma. Some investigations have proved that micrometastasis of axillary lymph node is an independent prognosis factor in breast carcinoma. There have been few studies for the dynamic changes on micrometastasis of bone marrow and peripheral blood. In this study, the changes of micrometastasis in bone marrow and peripheral blood were detected, and some regular patterns of micrometastasis and its effect of operation and of postoperative chemotherapy were surveyed in the patients with breast carcinoma. Studying the micrometastasis of bone marrow and blood could be helpful for the early diagnosis of distant metastasis and determination the treatment in breast carcinoma. Methods: The samples of peripheral blood and bone marrow were detected with CK-19mRNA by RT-PCR for 40 cases of breast carcinoma before operation. And the expression change of CK-19mRNA in peripheral blood was detected on the second day after operation and on the last day of the first course of postoperative chemotherapy. The samples of peripheral blood and bone marrow were detected in 10 cases of benign breast disease as the control group with the same method.Results: 1. The positive rate of CK-19mRNA expression in bone marrow was 22.50%(9/40). The positive rates of CK-19mRNA expression in the patients with 0 phase and I phase, II phase, III phase were 0%(0/6), 16.00%(4/25), 55.56%(5/9) respectively. There were remarkable significance of the difference in the positive rates between the different phases (P<0.05). The positive rates of CK-19mRNA expression in infiltrating ductal carcinoma and infiltrating lobular carcinoma were 26.92% and 28.57% respectively. The positive rates of CK-19mRNA expression had no significant difference between infiltrating ductal carcinoma and infiltrating lobular carcinoma.2. The positive rate of CK-19mRNA expression in blood was 22.50%(9/40) preoperatively. The positive rates of 0 phase and I phase, II phase, III phase were 0%(0/6), 16.00%(4/25), 55.56%(5/9) respectively. There was significant difference in the positive rates of different phases. The positive rates of CK-19mRNA expression in infiltrating ductal carcinoma and infiltrating lobular carcinoma were 23.07% and 33.33% respectively. The positive rates of CK-19mRNA expression had no significant difference between infiltrating ductal carcinoma and infiltrating lobular carcinoma.3. The positive rate of CK-19mRNA expression in blood on the second day after operation was 37.50%(15/40). There was no significant difference in the positive rates of CK-19mRNA expression in bloods between preoperative and the second day after operation.4. The positive rate of CK-19mRNA expression in blood on the last day of the first postoperative chemotherapy course was 2.50%(1/40). Postoperative chemotherapy showed a significant influence on the CK-19mRNA expression,compared with the results of those before operation. The positive rate of CK-19mRNA expression in blood decreased significantly after chemotherapy.Conclusion: A part of patients with breast carcinoma were found micrometastasis in their blood and bone marrow. The micrometastasis rate is higher in the patients with advanced period breast carcinoma than those in the early period. The relationships of micrometastasis positive rates of bone marrow and blood are not found between infiltrating ductal carcinoma and infiltrating lobular carcinoma. Operation management should be responsible for stimulating the tumor cell entrancing blood circulation. Surgeon should take skillful operative technique to avoid it. Postoperative chemotherapy should be a kind of routine treatment since it can decrease positive rate of micrometastasis significantly.