López Guerrero J A, Bolufer P, Barragán E, Sanz Alonso M, Palau J, Sempere A, De la Rubia J, Bonanad S, Torregrosa M D
Departmento de Biopatologia Clínica, Hospital Universitario La Fe, Valencia.
Sangre (Barc). 1996 Dec;41(6):441-6.
The sensitivity and specificity of a reverse transcription PCR method (RT-PCR) to detect cytokeratin K19 (CK19) expression was evaluated with the purpose of assessing its capability to detect the presence of breast cancer tumour cells in peripheral blood progenitor cell collection that had to be reinfused to breast cancer patients submitted to intensive chemotherapy as haematopoietic support.
Two breast cancers as positive samples were used and 34 samples of mononucleated blood cells as negative controls: 18 peripheral blood samples from normal subjects, 14 from different types of leukaemias (M3, M4Eo, M2, etc.) and two from two patients with Hodgkin's lymphoma. The method studied is a nested RT-PCR that amplifies the CK19 expression from the sample RNA extracted following the method of phenol-chloroform.
The right performance of the method is demonstrated by observing the detection of CK19 transcripts in the breast cancer RNA and by obtaining good blank results both with non transcribed RNA and with DNA. Moreover, the method has an excellent sensitivity such as to allow the detection of CK19 transcripts in a 10(-6) dilution of cDNA reverse transcribed from 1 microgram of breast cancer RNA. The CK19 transcripts were also detected in the 64% of RNA obtained from the mononucleated blood cells controls, although the percentage of positivities was lower (47%) in the RNA from peripheral blood samples. Nevertheless it should be remarked that the levels of CK19 expression in the blood mononucleated cells is almost negligible since it used to extinguish at 1:5 cDNA dilution.
The method studied is specific and has a high sensitivity that explains the detection of CK19 illegitimate expression approximately a half in mononucleated blood cells negative controls. However, the levels of CK19 expression in mononucleated blood cells were almost negligible and it used to extinguish at 1:5 cDNA dilution, therefore it could be concluded that the method might be useful to detect breast cancer occult tumours cells in mononucleated blood cell collection, always provided that a lower amount of cDNA is taken, thus decreasing to nil almost the false positive samples and keeping always a good sensitivity.
评估逆转录聚合酶链反应方法(RT-PCR)检测细胞角蛋白K19(CK19)表达的敏感性和特异性,以评估其检测外周血祖细胞采集中乳腺癌肿瘤细胞的能力,这些外周血祖细胞将被回输给接受强化化疗作为造血支持的乳腺癌患者。
使用两个乳腺癌样本作为阳性样本,34个单核血细胞样本作为阴性对照:18个来自正常受试者的外周血样本,14个来自不同类型白血病(M3、M4Eo、M2等)的样本,以及两个来自两名霍奇金淋巴瘤患者的样本。所研究的方法是一种巢式RT-PCR,它从按照苯酚-氯仿法提取的样本RNA中扩增CK19表达。
通过观察在乳腺癌RNA中检测到CK19转录本以及在非转录RNA和DNA中均获得良好的空白结果,证明了该方法的正确性能。此外,该方法具有出色的敏感性,以至于能够在从1微克乳腺癌RNA逆转录得到的cDNA的10^(-6)稀释液中检测到CK19转录本。在从单核血细胞对照获得的64%的RNA中也检测到了CK19转录本,尽管在外周血样本的RNA中阳性率较低(47%)。然而,应该指出的是,血液单核细胞中CK19的表达水平几乎可以忽略不计,因为它在cDNA 1:5稀释时就会消失。
所研究的方法具有特异性且灵敏度高,这解释了在单核血细胞阴性对照中约一半检测到CK19的异常表达。然而,单核血细胞中CK19的表达水平几乎可以忽略不计,并且在cDNA 1:5稀释时就会消失,因此可以得出结论,该方法可能有助于检测单核血细胞采集中的乳腺癌隐匿肿瘤细胞,前提是采用较少的cDNA量,从而几乎消除假阳性样本并始终保持良好的敏感性。