Detection of Circulating Tumor Cells in Venous Blood of Nasopharyngeal Carcinoma Patients by Nested Reverse Transcriptase-Polymerase Chain Reaction

以巢式反轉錄酶－聚合酶連鎖反應研究鼻咽癌病人血液中擴散癌細胞之偵測

林進清(Jin-Ching Lin) ； 蔡家興(Chia-Shing Tsai) ； 王文綺(Wen-Yi Wang) ； 詹建勝(Jian-Sheng Jan)

《The Kaohsiung Journal of Medical Sciences》 16卷1期 (2000/01) Pp. 1-8

https://doi.org/10.6452/KJMS.200001.0001

摘要

鼻咽癌對放射線敏感，近年由於放射腫瘤學進，腫瘤局部控制率提，治療失敗的主要原因是遠處轉移，本研究目的是建立式反轉錄酶一聚合連鎖反應，早期偵測鼻咽癌病人血液中癌細胞之可行性。共有40位經病理切片証實為鼻咽癌病患及20位健康人進入本研究，由取病人靜脈血10毫升，萃取血液細胞RAN，選用Cytoderatin 19 （CK-19）mRNA為標幟，進行巢式反轉錄酶－聚合酶連鎖反應，步結果顯示：治療過無病存活者9 例皆呈隃性反應，早期者（第一、二、三期）8 例中 2 例呈陽性反應（25%），晚期但無處轉移者（第只期M0）15 例中 6 例呈陽性各應（40.0%），8 例証實已生遠處轉移者 6 例呈陽性反應 (75.0%) ，20 位健康人皆呈陽性反應，以上收據顯示：本系統之性偵測率，隨鼻咽癌之嚴重度增高之趨勢，但其差異未達統計學意義 (p=0.11) ，值得長期追蹤病人並評估血液中CK-19陽性者，將來發生遠處轉移以及預後之關繴性，以確定其臨床應用價值。

並列摘要

Nasopharyngeal carcinoma (NPC) is a radiosensitive tumor. Because of recent advances in radiation oncology, distant metastasis bas become the predominant failure site after adequate radiotherapy. The purpose of this study is to establish a nested reverse transcriptase-polymerase chain reaction (RT-PCR) system and to evaluate the potential of cytokeratin 19 (CK- 19) mRNA as a target for detecting micrometastasis in the blood of NPC patients. Venous blood samples from 40 patients with biopsy-proven NPC (25 previously untreated and 15 after radiotherapy) and 20 healthy volunteers were tested. We divided the 40 patients into 4 groupS: cured, early stage, advanced stage, and metastasized, according to results of clinical staging workup. Under our nested RT-PCR experimental conditions, 2 of 8 early stage patients (25.0%), 6 of 15 advanced stage patients (40%), and 6 of 8 patients with distant metastasis (75%) had CK-19 positive cells in peripheral blood (P=O.l1). No CK-19 positive cells were detected in 9 “cured” patients and 20 healthy volunteers. Our data indicated that the positive detection rate for CK-19 rnRNA in peripheral blood increased as the clinical stage of disease increased, but the difference did not reach statistical significance. Longerfollow-up is needed to assess the significance of CK-19 mRNA in blood, as well as its relation to subsequent metastasis and prognosis of NPC.

並列關鍵字

nasopharyngeal carcinoma ； cytokeratin ； polymerase chain reaction