| Lung cancer is one of the tumors, which has increasing incidence and mortality, and the worst prognosis.Metastasis is the characteric mark malignant of tung cancer and the direct reason to cause the patient to die, it is the base of metastasis and reoccur of alive tumor cell in circulatory system. In the earlier stage of metastasis the number of cancer cell is few ,the site is small, and it is sensitive to chemical drugs, if we can examine and find out the number of the tumor cells in the circulatory system and specific chemotherapy and wholly assistance treatment, we can promote the effects greatly. If we miss the chance, the tumor will grow bigger and extent rapidly, at the same time a number lack-oxygen cells will grow and cause great effect to the final result. At present, it lacks a direct index to judge whether a the patient need the chemotherapy or not, if we can distinguish the patient with micrometastasis tumor cells in circulatory system from the normal ones, and put a suitable chemotherapy, we can highly promote the effects of treatment in theory as well as avoid the unnecessary treatment to the others, thus promote the whole living standards of the patients. So, for the decision of clinical plan and heals of the patient, it'svery important to diagnose how the cancer cells transfers in the early stage. However, the number of this type of cells is very tiny,and the specific protein is also deficient and uneasy to be examined by the normal clinical techniques. So, to seek the particular mark and form a high sensitive examination method to examine the tumor cells in patient circulatory system, have clinical importance to the diagnosis of lung cancer, period judging and prognosis. CK19 belongs to cytokeratins categories (CKS), which consists of 20 members with molecular weight from 40KD to 68KD. And it is mainly expressed in epithelial cells and epithelium tumor cells but not expressed in other tissues. However, due to the false genetic disturbance in non-epithelium, CK18 is affected upon the test results. CK19 cannot be expressed in normal lymph node, circumferential blood and marrow. Therefore, lung cancer can be judged through monitoring the conditions of CK19-mRNA.To find the clinical relationship of CK19-mRNA in peripheral blood and regional lymph nodes, we adopt the nested RT-PCR to examine the expression of CK19-mRNA in the lung cancer group, the positive pathological changes group, and the healthy group respectively. Then, to find out whether CK19-mRNA is the peculiar mark of micrometastasis of lung cancer and the possibility of putting nested RT-PCR into practice in the examination of micrometastasis of lung cancer.Materials and Methods1. Materials: All the patients were chosen from the department of thoracic surgery in Henan Chest Hospital and Henan Province Hospital. 5ml fresh blood with heptin was picked before operation .All the collected lymph nodes in lung near the hilus and mediastium were cut into two parts, one parts was used as ordinary HE dying, and the other were fast frozen by liquid nitrogen and then were kept in refrigerator at -80 C for RNA detection. 2 Groups:(1)Lung cancer group: 76 cases were obtained from January 2001 to January 2003, 54 males, 22 females, the average age was 56.8+7.8years old, the classify and TNM stage were based upon the international standard UICC1997. Classified by pathology: 38cases with squamous cell cancer, 27cases with adenocarcinoma, 11 cases with small cell cancer; 20 cases were in Low differentiation, 35 cases in moderate differentiation, 21 cases in high differentiation; Classified by P-TNM stage: 7 cases in stage la, 9 cases in stage Ib, 13 cases in stage II a, 15 cases in stage II b, 12 cases in stage IIIa , 7cases in stage IIIb and 13cases in stage IV; 23 cases had Lymph nodes metastases, lOcases had distance metastases (5 cases in supraclavicular lymph nodes, 2 cases in pleura, 1 case in brain, 1 case in bone, 1 case in liver).(2)Pulmonary benign diseases group: 27 cases, 17 males 10 females, the average age was 55.6+ 7.5yea... |
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