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CK19 Detection by Multiplex Real-Time RT-PCR Correlates with the Presence of Angiolymphatic and Perineural Invasion in Sentinel Lymph Nodes of Thai Breast Cancer Patients

Tanawan Kummalue, Monthira Suntiparpluacha, Kannika Tongkao, Tuenjai Chuangsuwanich, Tawatchai Pongpruttipan and Pornchai O-charoenrat

Abstract
Background: Pathological evaluation of sentinel lymph nodes of breast cancer patients is a critical factor in
determining the treatment strategy including patients’ outcome. Multiple factors have been known to correlate with
disease free survival and clinical outcomes such as sentinel lymph node metastases. Recently, real-time RT-PCR
which is a very useful, rapid, high sensitivity and specificity tool has been reported to detect micrometastases in
sentinel lymph nodes which could be helpful to identify high risk patients.
Objectives: The purpose of this study are: To evaluate the sensitivity, specificity, and accuracy of CK19
detection by multiplex real-time RT-PCR and to elucidate the correlation of multiplex real-time RT-PCR results and
clinicopathological parameters in sentinel lymph nodes of Thai breast cancer patients.
Material and methods: 119 patients diagnosed as breast cancer stage I or II at Siriraj Hospital during October
2008 – June 2010 were enrolled in this study. RNAs were extracted from their sentinel lymph nodes and cDNAs were
synthesized. Multiplex real-time RT-PCR for detection of CK19 was performed and analysed. Patients’ characteristics
and pathological parameters were compared with multiplex real-time RT-PCR results.
Results: Significant correlation between angiolymphatic and perineural invasion status and CK19 expression was
demonstrated. The overall concordance of CK19 gene with pathological results was 72.3%. Sensitivity and specificity
for CK19 detected by multiplex real-time RT-PCR were 78.3%, and 66.1%, respectively.
Conclusion: Significant correlation between angiolymphatic and perineural invasion status and CK19 expression
in sentinel lymph nodes of breast cancer patients was found in this study.

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