Fujii Y, Kageyama Y, Kawakami S, Kihara K, Oshima H
Department of Urology, Tokyo Medical and Dental University School of Medicine, Tokyo.
Jpn J Cancer Res. 1999 Jul;90(7):753-7. doi: 10.1111/j.1349-7006.1999.tb00811.x.
More than half of all patients with invasive urothelial cancer subsequently develop metastatic disease even after radical resection of the primary cancer. In these patients, neoplastic cells may be disseminated prior to or during the operation. A nested reverse transcriptase-polymerase chain reaction (nested RT-PCR) assay which amplifies cytokeratin (CK) 20 transcripts was used to detect cancer cells in the peripheral blood of urothelial patients. This assay was able to detect 10 bladder cancer cell line cells in a sample of ten million peripheral-blood mononuclear (PBMN) cells. CK 20-specific signals were detected in 9 (22.5%) of 40 PBMN cell samples prepared from 40 urothelial cancer patients in relation to the tumor stage, including 0/13 patients with a superficial tumor, 4/21 (19%) with a regionally invasive tumor and 5/6 (83%) with a metastatic tumor (P = 0.0002 in chi 2 test). No signals were detected in any of 25 healthy donor PBMN cell samples. The present results indicate that the CK 20 RT-PCR assay is applicable for detection of urothelial cancer cells in the peripheral blood. The assay also confirms that hematogenic dissemination occurs in invasive urothelial cancers but rarely in superficial ones.
超过半数的浸润性尿路上皮癌患者即使在原发癌根治性切除后仍会发生转移性疾病。在这些患者中，肿瘤细胞可能在手术前或手术过程中就已播散。一种用于扩增细胞角蛋白（CK）20转录本的巢式逆转录聚合酶链反应（nested RT-PCR）检测法被用于检测尿路上皮癌患者外周血中的癌细胞。该检测法能够在一千万个外周血单个核（PBMN）细胞的样本中检测到10个膀胱癌细胞系细胞。在从40例尿路上皮癌患者制备的40个PBMN细胞样本中，根据肿瘤分期检测到9例（22.5%）有CK 20特异性信号，其中浅表肿瘤患者0/13例，局部浸润性肿瘤患者4/21例（19%），转移性肿瘤患者5/6例（83%）（卡方检验P = 0.0002）。在25例健康供者的PBMN细胞样本中均未检测到信号。目前的结果表明，CK 20 RT-PCR检测法适用于检测外周血中的尿路上皮癌细胞。该检测法还证实，血行播散发生在浸润性尿路上皮癌中，但在浅表性尿路上皮癌中很少见。
