The significance of CK19mRNA expression in patients with breast cancer and the effect of adjuvant chemotherapy on bone marrow micrometastasis

Objective To study the micrometastasis in peripheral blood,lymph node and bone marrow in patients with breast cancer and the effect of adjuvant chemotherapy on bone marrow micrometastasis.Methods RT-PCR technique was used to simultaneously detect the micrometastasis in peripheral blood,lymph node and bone marrow in 69 patients with operable breast cancer,and the effect of adjuvant chemotherapy on bone marrow micrometastasis was also investigated.Results The positivity of bone marrow micrometastasis tested by RT-PCR in breast cancer patients was 34.8%.The circulating tumor cells were found in 11 patients(15.9%).Lymph node metastasis was positive in 35 cases, out of the 35 node-positive cases,32 cases(91.4%) were lymph node micrometastasis,out of the 34 node-negative cases,eight cases(23.5%) were lymph node micrometastasis.Seven of 24 cases(29.2%) of bone marrow micrometastasis positive patients became negative after receiving six cycles of CAF adjuvant chemotherapy.Conclusions Detection of CK19mRNA by RT-PCR is a sensitive and specific method of assessing micrometastasis in patients with breast cancer.Compared with the detection of bone marrow micrometastasis,the technique to detect the micrometastasis in peripheral blood is less sensitive or specific.The detection of bone marrow micrometastasis is a sensitive index to assess the effect of adjuvant chemotherapy.