CK19 mRNA in blood can predict non-sentinel lymph node metastasis in breast cancer
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Xing-Fei Yu1,2,*, Hong-Jian Yang2,*, Lei Lei3, Chen Wang2, Jian Huang1
1Department of Surgical Oncology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, P.R.China
2Department of Breast Tumor Surgery, Zhejiang Cancer Hospital, Banshan Bridge, Hangzhou, Zhejiang Province, 310022, P.R.China
3Department of Breast Medical Oncology, Zhejiang Cancer Hospital, Banshan Bridge, Hangzhou, Zhejiang Province, 310022, P.R.China
*These authors contributed equally to this work
Jian Huang, e-mail: [email protected]
Keywords: breast cancer, CK19, non-sentinel lymph node, metastasis, biomarker
Received: November 06, 2015 Accepted: March 31, 2016 Published: April 20, 2016
Reverse-transcription polymerase chain reaction (RT-PCR) is used to detect CK19 mRNA in sentinel lymph node biopsy (SLNB) tissues from breast cancer patients. We examined whether CK19 mRNA in peripheral blood is predictive of non-sentinel lymph node (nSLN) metastasis. Breast cancer cases diagnosed with clinical stage cT1–3cN0 and registered in our medical biobank were identified retrospectively. This study then included 120 breast cancer cases treated at Zhejiang Cancer Hospital from Aug 2014 to Aug 2015, including 60 SLN-positive and 60 SLN-negative cases. CK19 mRNA levels in peripheral blood samples were assessed using RT-PCR prior to tumor removal. During surgery, if SLNB tissue showed evidence of metastasis, axillary lymph node dissection (ALND) was performed. No ALND was performed if SLNB and nSLN tissues were both negative for metastasis. CK19 expression was higher in nSLN-positive patients than in nSLN-negative patients (p < 0.05). Logistic regression indicated that lymphatic vessel invasion and CK19 levels were predictive of nSLN status (p < 0.05). The area under the ROC curve for CK19 was 0.878 (p < 0.05). We conclude that high CK19 levels in peripheral blood may independently predict nSLN metastasis in breast cancer patients.
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