乳腺癌相关基因CK19与Vimentin mRNA联合检测在乳腺癌中的临床应用

doi:10.3877/cma.j.issn.1674-3946.2021.04.019

目的

探讨逆转录聚合酶链反应(RT-qPCR)法检测乳腺癌患者外周血中CK19、Vimentin mRNA表达量及临床意义。

方法

RT-qPCR法测定73例乳腺癌患者和24例健康女性体检者外周血中CK19与Vimentin mRNA的表达量。使用SPSS20.0软件进行统计分析，CK19与Vimentin mRNA表达量等计量资料等用(±s)表示，组间比较采用独立t检验。受试者工作特征曲线(ROC曲线)通过建立二元Logistc回归模型绘制，分析外周血中CK19与Vimentin及二者联合对乳腺癌诊断的潜在价值。以P<0.05为差异有统计学意义。

结果

CK19与Vimentin的mRNA在乳腺癌组的表达量大于健康对照组(P<0.05)。CK19诊断乳腺癌的ROC曲线下面积(AUC)为0.689，灵敏度63%，特异度75%。Vimentin AUC为0.709，灵敏度41.1%，特异度91.7%。二者联合诊断乳腺癌的AUC为0.740。CK19 mRNA表达量与乳腺癌患者是否绝经相关(P<0.05)。

结论

CK19与Vimentin mRNA在乳腺癌患者中表达均上调，对乳腺癌有良好的诊断效能，可能是乳腺癌辅助诊断的潜在生物标志物。

关键词: 乳腺肿瘤, 波形蛋白, 逆转录聚合酶链反应, 细胞角蛋白19

Objective

To explore the use of reverse transcription polymerase chain reaction (RT-qPCR) detecting the expression of CK19 and Vimentin mRNA in the peripheral blood of patients with breast cancer and its clinical significance.

Methods

Using RT-qPCR detect CK19 and Vimentin mRNA expression in peripheral blood of 73 patients with breast cancer and 24 healthy controls. Spss20.0 software was used for statistical analysis. CK19 and Vimentin mRNA expression and other measurement data were expressed as (±s). Independent t test was used for comparison between groups. Receiver operating characteristic curve (ROC) was drawn by establishing binary logistic regression model. Analyze the potential value of CK19, Vimentin and their combination in the peripheral blood for the diagnosis of breast cancer. A P value of <0.05 was considered as statistically significant difference.

Results

The expression of CK19 and vimentin mRNA in breast cancer group were significantly higher than those in healthy control group (P<0.05). The area under ROC curve (AUC) of CK19 was 0.689, the sensitivity was 63.0%, and the specificity was 75%. The AUC of vimentin was 0.709, the sensitivity was 41.1%, and the specificity was 91.7%. While the AUC of CK19 combined with Vimentin in the diagnosis of breast cancer was 0.740. The expression of CK19 mRNA was associated with menopausal status of breast cancer patients (P<0.05).

Conclusion

Both CK19 and Vimentin mRNA are up-regulated in patients with breast cancer, which have satisfactory diagnostic efficiency for breast cancer and probably become the potential biomarkers to assist the diagnosis of breast cancer.

Key words: Breast neoplasms, Vimentin, Reverse transcriptase polymerase chain reaction, Cytokeratin 19

图1 CK19、Vimentin与GAPDH1扩增曲线图

表1 CK19与Vimentin mRNA在乳腺癌组和健康对照组的表达情况

组别	例数	CK19	Vimentin
健康对照组	24	0.69±0.50	0.92±0.34
乳腺癌组	73	1.55±1.57^a	1.16±0.37^a

表1 CK19与Vimentin mRNA在乳腺癌组和健康对照组的表达情况

组别	例数	CK19	Vimentin
健康对照组	24	0.69±0.50	0.92±0.34
乳腺癌组	73	1.55±1.57^a	1.16±0.37^a

图2 乳腺癌组与健康对照组CK19与Vimentin的ROC曲线图

表2 73例乳腺癌患者CK19与Vimentin mRNA诊断效率的比较(%)

项目	灵敏度	特异度	阳性似然比	阴性似然比	AUC	95%CI
CK19	63.0	75.0	88.46	40.0	0.689	0.587～0.779
Vimentin	41.1	91.67	93.75	33.85	0.709	0.608～0.796
CK19+Vimentin	64.38	79.2	90.38	42.22	0.740	0.641～0.824

表2 73例乳腺癌患者CK19与Vimentin mRNA诊断效率的比较(%)

项目	灵敏度	特异度	阳性似然比	阴性似然比	AUC	95%CI
CK19	63.0	75.0	88.46	40.0	0.689	0.587～0.779
Vimentin	41.1	91.67	93.75	33.85	0.709	0.608～0.796
CK19+Vimentin	64.38	79.2	90.38	42.22	0.740	0.641～0.824

表3 CK19和Vimentin表达量与73例乳腺癌患者临床特征的相关性

病理特征		例数	CK19	P值	Vimentin	P值
年龄(岁)
	<50	42	1.31±1.22	0.271	1.22±0.44	0.112
	≥50	31	1.67±1.51	0.271	1.08±0.25	0.112
绝经状态
	绝经前	51	1.22±1.13	0.047	1.19±0.41	0.357
	绝经后	22	2.02±1.65	0.047	1.10±0.27	0.357
淋巴结转移
	是	32	1.21±1.23	0.296	1.15±0.36	0.933
	否	41	1.55±1.38	0.296	1.16±0.42	0.933
Ki67
	≥15%	59	1.47±1.36	0.933	1.17±0.40	0.471
	<15%	14	1.44±1.35	0.933	1.09±0.27	0.471
临床分期
	Ⅰ+Ⅱ期	62	1.50±1.40	0.38	1.18±0.39	0.216
	Ⅲ+Ⅳ期	11	1.26±1.07	0.38	1.04±0.23	0.216
ER状态
	阳性	44	1.33±1.27	0.292	1.09±0.31	0.060
	阴性	29	1.67±1.46	0.292	1.26±0.44	0.060
PR状态
	阳性	36	1.41±1.37	0.758	1.24±0.40	0.071
	阴性	37	1.51±1.35	0.758	1.08±0.33	0.071
CerbB-2
	阳性	32	1.40±1.41	0.742	1.11±0.37	0.384
	阴性	41	1.51±1.32	0.742	1.19±0.38	0.384

表3 CK19和Vimentin表达量与73例乳腺癌患者临床特征的相关性

病理特征		例数	CK19	P值	Vimentin	P值
年龄(岁)
	<50	42	1.31±1.22	0.271	1.22±0.44	0.112
	≥50	31	1.67±1.51	0.271	1.08±0.25	0.112
绝经状态
	绝经前	51	1.22±1.13	0.047	1.19±0.41	0.357
	绝经后	22	2.02±1.65	0.047	1.10±0.27	0.357
淋巴结转移
	是	32	1.21±1.23	0.296	1.15±0.36	0.933
	否	41	1.55±1.38	0.296	1.16±0.42	0.933
Ki67
	≥15%	59	1.47±1.36	0.933	1.17±0.40	0.471
	<15%	14	1.44±1.35	0.933	1.09±0.27	0.471
临床分期
	Ⅰ+Ⅱ期	62	1.50±1.40	0.38	1.18±0.39	0.216
	Ⅲ+Ⅳ期	11	1.26±1.07	0.38	1.04±0.23	0.216
ER状态
	阳性	44	1.33±1.27	0.292	1.09±0.31	0.060
	阴性	29	1.67±1.46	0.292	1.26±0.44	0.060
PR状态
	阳性	36	1.41±1.37	0.758	1.24±0.40	0.071
	阴性	37	1.51±1.35	0.758	1.08±0.33	0.071
CerbB-2
	阳性	32	1.40±1.41	0.742	1.11±0.37	0.384
	阴性	41	1.51±1.32	0.742	1.19±0.38	0.384

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Clinical application of combined detection of breast cancer related gene CK19 with Vimentin mRNA in breast cancer

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Clinical application of combined detection of breast cancer related gene CK19 with Vimentin mRNA in breast cancer