DOI: 10.4103/jpdtsm.jpdtsm_14_26 ISSN: 2949-6594

Cytokeratin 19 Gene Expression in Patients undergoing Lung Computed Tomography Scan: With and without Bismuth Shield

Abdolreza Mohamadnia, Naghmeh Bahrami, Shadi Shafaghi, Masoume Avateffazeli, Neda Moattar Husseini
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BACKGROUND:

Lung computed tomography (CT) scan is one of the most widely used imaging methods that exposes patients to ionizing radiation. This radiation can cause molecular changes, including changes in gene expression. The aim of this study was to evaluate and compare cytokeratin 19 (CK19) gene expression in patients undergoing lung CT scan with a bismuth shield, without a bismuth shield, and healthy subjects.

MATERIALS AND METHODS:

In this study, peripheral blood samples were collected from three groups, including patients undergoing a CT scan with a bismuth shield ( n = 30), patients without a shield ( n = 30), and healthy controls ( n = 30). Ribonucleic acid (RNA) extraction and complementary DNA synthesis were performed, and CK19 gene expression was measured using real-time polymerase chain reaction.

RESULTS:

CK19 mRNA positivity differed significantly across groups ( P < 0.001), reaching 93.3% (28/30) in the nonshield group, 83.3% (25/30) in the shield group, and 30.0% (9/30) in controls. Compared with controls, positivity was higher in both CT groups (nonshield: risk ratio [RR]: 3.11, 95% confidence interval [CI]: 1.79–5.42; shield: RR: 2.78, 95% CI: 1.57–4.91), whereas the difference between CT groups was smaller (RR: 1.12, 95% CI: 0.93–1.35). Relative CK19 expression was also higher in CT-exposed patients, with fold changes of 1.3 (nonshield) and 1.1 (shield).

CONCLUSION:

Bismuth shielding may attenuate CT-associated changes in CK19; however, the difference between shielded and nonshielded patients was modest. Further studies with larger samples, standardized sampling, and detailed CT dose data are needed.

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