유방암 환자에서의 골수 미세전이가 재발과 생존에 미치는 영향
Influence of Bone Marrow Micrometastasis in Recurrence and Survival of Breast Cancer
정용식, 차진우, 박희붕, 김혜진, 소의영, 김명욱,
소속 상세정보
정용식 ( Jung Yong-Sik )
아주대학교 의과대학 외과학교실
차진우 ( Cha Jin-Woo )
아주대학교 의과대학 외과학교실
박희붕 ( Park Hee-Boong )
아주대학교 의과대학 외과학교실
김혜진 ( Kim Hae-Jin )
아주대학교 의과대학 외과학교실
소의영 ( Soh Euy-Young )
아주대학교 의과대학 외과학교실
김명욱 ( Kim Myung-Wook )
아주대학교 의과대학 외과학교실
KMID : 0371320020630050384
Abstract
Purpose: Breast cancers frequently develop distant metastasis in the early phase. The survival rate of patients depends on a distant metastasis. The occurrence of a micrometastasis has been related to the prognostic features of breast
cancer,
such as a lymph node metastasis and the presence of a vascular invasion. The aim of this study was to examine the presence of RNA from epithelial tumors in bone marrow from a series of breast cancer patients and its correlation with the tumor
staging
and disease free survival.
Methods: Bone marrow samples were obtained from 59 patients with breast cancer at the time of surgery. The mononuclear fraction was separated and a nested reverse transcriptase polymerase chain reaction (RT-PCR) was carried out for the
detection
of keratin-19 with different two pairs of primers. After surgery, the patients were followed up for a 3-month interval. Its correlation with the tumor size, nodal involvement, stage, and recurrence was investigated.
Results: A bone marrow micrometastasis was detected by nested RT-PCR for Keratin-19 mRNA in one case in 4 DCIS, 13 in 30 patients with T1, 11 in 20 patients with T2, and all 4 cases in patients with a T3 lesion. Recurrence was observed in 7
cases
and all of them tested positive for a micrometastasis in the bone marrow.
Conclusion: The nested RT-PCR for keratin-19 mRNA from the bone marrow in patients with breast cancer is sensitive and reliable. Moreover, early recurrence has been observed in patients with tumor mRNA present in the bone marrow.
Additional
studies with a large number of patients and a long term follow up are needed.
키워드
유방암; 미세전이; 역전사 중합효소반응; Breast cancer; Micrometastasis; Keratin-19; Nested RT-PCR;
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