Clinical Research On Detecing Of The Combined Survivin MRNA With Cytokeratin 19(ck19) MRNA In Peripheral Blood Of Non-small Cell Lung Cancer

Objective: The aim of this study is to evaluate clinic value whether the combined Survivin mRNA with cytokeratin 19(CK19) mRNA would improve the diagonosis of non-small cell lung cancer and identify early micrometastases status by detecting the expression of Survivin mRNA and cytokeratin 19 (CK19) mRNA in peripheral blood of non-small cell lung cancer patients and comparied with CEA and CYFRA21-1.Methods: We used reverse transcription polymerase chain reaction (RT-PCR) to determine the expression of Survivin mRNA and CK19 mRNA in peripheral blood in 55 cases of non-small cell lung cancer(NSCLC) patients, 30 cases of benign lung diseases (BLD) patients and 30 cases of healthy persons as control. Meanwhile ,the serum levels of CEA and CyFRA21-1 was determined by electro-chemiluminescense immunoassay (ECLI). It was analyzed that the relationship of the expression with clinical pathological factors.The data was analyzed by X2 text.Results: The positive rate of Survivin mRNA and CK19 mRNA expression was 61.82%(34/55), 49.09%(27/55)in peripheral blood of NSCLC patients; and 6.67%(2/30),16.67%(5/30)in patients with BLD , respectively. No positive Survivin mRNA and CK19 mRNA expression was found in peripheral blood of healthy persons as control,showing a statisticall significant difference between NSCLC group and BLD group, and between NSCLC group and healthy controls group. ( P < 0.01). The positive rate of Survivin mRNA and CK19 mRNA expression were sig -nificant correlation with the TNM staging ( P<0.01 ) ,but no statistical difference about gender, age, histopathologic types. (P>0.05). The positive rate of CEA and CYFRA21-1 expression were 43.64%(24/55),34.55%(19/55)in peripheral blood of NSCLC patients, respectively. The positive rate of CEA and CYFRA21-1 expression were significant correlation with the TNM staging and histopathologic types(P<0.05). Sensitivity , specificity, accuracy of Survivin mRNA combined detection with CK19 mRNA were 80.00%(44/55),90%(54/60),85.22%(98/115)and those of CEA combined detection with CYFRA21-1 were 50.91%(28/55),85% (51/60),68.70% (79/115)respectively . Sensitivity and accuracy was statistical difference between two groups(P <0.05),but no statistical difference about specificity between two groups(P >0.05).Conclusions:1 Positive expression of Survivin mRNA was significantly higher in peripheral blood of NSCLC patients than those of CK19 mRNA,CEA,CYFRA21-1. Survivin mRNA can be used as a valuable tumor marker for diagnosis of micrometastasis in patients with NSCLC.2. Sensitivity , accuracy of Survivin mRNA combined detection with CK19 mRNA were higher than those of CEA with CYFRA21-1. The combined detection of Survivin mRNA with CK19 mRNA can increase diagnosis rate of NSCLC and early detect micrometastasis, so as to guide clinical diagnosis.3. CEA was more sensitive for adenocarcinomas than for squamous cell cancers, compared with CYFRA21-1for the contrary. These two markers can be used for early diagnosis of pathological typing of NSCLC.