Prognostic value of quantitative reverse transcription-polymerase chain reaction in lymph node-negative esophageal cancer patients.
Prognostic value of quantitative reverse transcription-polymerase chain reaction in lymph node-negative esophageal cancer patients.
复制标题
定量逆转录聚合酶链反应对淋巴结阴性食管癌患者的预后价值。
DOI：
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发表时间：
2001
影响因子：
11.5
通讯作者：
J. Luketich
中科院分区：
文献类型：
--
作者：
Tony E. Godfrey;Siva Raja;Sydney D. Finkelstein;William E. Gooding;Lori A. Kelly;J. Luketich
目的
在食道癌中，淋巴结转移是复发和预后不良的最强预测因子。然而，尽管有可能进行根治性切除，许多结节阴性的患者仍会复发。这可能是组织学检查遗漏了显微镜下的隐匿性转移所致。在这项研究中，我们用标准的胶基逆转录-聚合酶链式反应(RT-PCR)和Taqman定量RT-PCR(QRT-PCR)检测了30例组织学阴性的食道癌患者387枚淋巴结中的癌胚抗原(CEA)mRNA。
实验设计
将CEA的表达与临床结果进行比较，以确定与疾病复发的相关性。对于定量数据，最佳CEA表达水平截断值被定义为根据疾病复发对患者进行最准确分类的值。绘制Kaplan-Meier生存曲线，并进行多因素分析评价QRT-PCR的预后价值。
结果
在12个组织块中，CEA表达水平高于最佳截止水平，从而确定了11名CEA阳性患者。在这些患者中，9例复发，2例无病。19例CEA阴性患者中有1例复发。预测复发的敏感性和特异性分别为90%和90%。Kaplan-Meier分析显示CEA阳性患者的无病生存率和总生存率显著降低(P<；分别为0.0001和0.0006)。在多变量分析中，在所检测的其他临床和病理因素中，QRT-PCR检测的CEA阳性是最强的独立预测疾病复发的因素。
结论
定量逆转录聚合酶链式反应比标准逆转录聚合酶链式反应具有显著的优势，并能识别出复发风险较高的结节阴性患者。
PURPOSE
In esophageal cancer, lymph node metastases are the strongest predictor of recurrence and poor outcome. However, many node-negative patients still recur despite a potentially curative resection. This is probably the result of microscopically occult metastases missed by histological examination. In this study, we used both standard, gel-based reverse transcription-PCR (RT-PCR) and Taqman quantitative RT-PCR (QRT-PCR) for carcinoembryonic antigen (CEA) mRNA to detect occult micrometastases in 387 lymph nodes from 30 histologically node-negative esophageal cancer patients.
EXPERIMENTAL DESIGN
CEA expression was compared with clinical outcomes to determine correlation with disease recurrence. For quantitative data, an optimum CEA expression level cutoff value was defined as the value that most accurately classified patients on the basis of disease recurrence. Kaplan-Meier survival curves were generated, and multivariate analyses were performed to evaluate the prognostic value of QRT-PCR.
RESULTS
CEA expression levels were above the optimum cutoff level in 12 tissue blocks, resulting in the identification of 11 CEA-positive patients. Of these patients, 9 suffered disease recurrence and 2 remain disease free. Of the 19 CEA-negative patients, there was 1 disease recurrence. The sensitivity and specificity for predicting disease recurrence were 90 and 90%, respectively. Kaplan-Meier analysis showed that CEA positivity resulted in significantly lower disease-free and overall survival (P <0.0001 and 0.0006 respectively). In multivariate analyses, CEA positivity measured by QRT-PCR was the strongest independent predictor of disease recurrence among other clinical and pathological factors examined.
CONCLUSIONS
QRT-PCR offers significant benefits over standard RT-PCR and identifies node-negative patients at high risk for recurrence.
影响因子：
4.1
作者：
Godfrey, TE;Kim, SH;Jensen, RH
通讯作者：
Jensen, RH
早期黑色素瘤患者通过前哨淋巴结切除术和逆转录聚合酶链反应检测到的隐匿性转移的预后意义。
DOI：
10.1200/jco.1999.17.10.3238
发表时间：
1999
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Bostick,PJ;Morton,DL;Turner,RR;Huynh,KT;Wang,HJ;Elashoff,R;Essner,R;Hoon,DS
通讯作者：
Hoon,DS
影响因子：
9.8
作者：
Tassone, F;Hagerman, RJ;Hagerman, PJ
通讯作者：
Hagerman, PJ