Immunology and Reproduction Biology Lab, Medical School and State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing 210093, China.
J Cancer Res Clin Oncol. 2013 Apr;139(4):543-9. doi: 10.1007/s00432-012-1359-z. Epub 2012 Dec 5.
The detection of circulating nucleic acids has long been explored for the diagnosis and prognosis of a variety of clinical conditions. The aim of this study was to detect the cell-free mRNA expression of midkine (MK) in patients with effusions and its potential diagnostic and predictive value.
Effusions were collected prospectively from 168 patients. The cell-free RNA was extracted from effusions, and the mRNA expression of MK was detected using real-time PCR. The expression of carcinoembryonic antigen (CEA) and biochemical markers in effusions were also assayed. Primary cancer cells were isolated from the malignant effusions (n = 46). Compared with culture cell lines, the response of these cancer cells to chemotherapeutic agents was determined by CCK-8 assay.
The expression of cell-free MK mRNA was significantly higher in the malignant group than in the benign group (0.13 vs 0.01, P < 0.001). The sensitivity and diagnostic accuracy of MK were 77.5 and 81.5 %, while a combination of CEA and MK reached 86.9 % sensitivity and 88.7 % accuracy. In addition, cell-free MK mRNA expression was significantly correlated with inhibitory rate of cisplatin (R = -0.72, P < 0.01).
Measurement of cell-free MK mRNA levels in effusion supernatant yields a high diagnostic accuracy and a potential predictive value.
游离核酸的检测长期以来一直被用于各种临床情况的诊断和预后。本研究旨在检测患者胸腔积液中中期因子（MK）的游离 mRNA 表达及其潜在的诊断和预测价值。
前瞻性收集 168 例患者的胸腔积液。从胸腔积液中提取游离 RNA，采用实时 PCR 检测 MK 的 mRNA 表达。还检测了胸腔积液中癌胚抗原（CEA）和生化标志物的表达。从恶性胸腔积液中分离出原代癌细胞（n = 46）。与培养细胞系相比，通过 CCK-8 测定法确定这些癌细胞对化疗药物的反应。
恶性组细胞游离 MK mRNA 的表达明显高于良性组（0.13 对 0.01，P < 0.001）。MK 的灵敏度和诊断准确性分别为 77.5%和 81.5%，而 CEA 和 MK 的联合检测灵敏度达到 86.9%，准确性达到 88.7%。此外，游离 MK mRNA 表达与顺铂抑制率显著相关（R = -0.72，P < 0.01）。
胸腔积液上清液中游离 MK mRNA 水平的测量具有较高的诊断准确性和潜在的预测价值。
