实时定量逆转录聚合酶链反应检测大肠癌患者术前外周血 CK20 mRNA和CEA mRNA的临床意义_临床医学论文.docVIP

实时定量逆转录聚合酶链反应检测大肠癌患者术前外周血 CK20 mRNA和CEA mRNA的临床意义_临床医学论文 实时定量逆转录聚合酶链反应检测大肠癌患者术前外周血 CK20 mRNA和CEA mRNA的临床意义_临床医学论文 作者：周海茵，葛成华，王世伟，叶古祥，唐文贤，赵旭鸿，范珍妮 【摘要】 目的 探讨大肠癌患者外周血CK20 mRNA和CEA mRNA的表达及其临床意义。方法 采用实时定量逆转录聚合酶链反应（QRT-PCR）技术，对68例大肠癌患者及30例健康志愿者（对照组）术前外周血CK20 mRNA和CEA mRNA水平进行检测。结果 在对照组中CK20 mRNA和CEA mRNA 均无表达，而在大肠癌组中CK20 mRNA阳性表达率为45.6%，CEA mRNA阳性表达率为39.7%，二者联合检测阳性率为55.9%，较单项检测阳性率高（Pgt;0.05），二者的表达与性别、肿瘤部位和肿瘤分化程度无明显相关，与肿瘤临床分期、淋巴结转移和肝脏转移明显相关。结论 CK20 mRNA和CEA mRNA可作为大肠癌细胞血行播散的标志，联合检测有助于提高肿瘤微转移的检出率及判断预后。 【关键词】 大肠肿瘤；微转移；外周血 ［Abstract］ Objective To investigate the expression of CK20 mRNA and CEA mRNA in peripheral blood of patients with colorectal cancer and its clinical significance.Methods CK20 mRNA and CEA mRNA were detected in 68 patients with colorectal cancer before operation,30 health adults by QRT-PCR.Results CK20 mRNA and CEA mRNA were undetected in the control group,the positive rate of CK20 mRNA among colorectal cancer patients was 45.6%,and of CEA mRNA was 39.7%.The positive rate of combination detection was 55.9%.It was higher than the rate of detection alone.There was no statistically significant difference of positive rate between two detection methods.The expression of CK20 mRNA and CEA mRNA were not significantly correlated with sex of patients,the place of the tumor or differentiation level of cancer cells,but correlated with clinical stage,lymph nodes metastasis and liver metastasis.Conclusion CK20 mRNA and CEA mRNA were useful maker of blood dissemination of colorectal cancer cell and the positive rate of micrometastasis be maybe raised by combination detection.The expression of CK20 mRNA and CEA mRNA may be regarded as a reference indicator. ［Key words］ colorectal cancer;micrometastasis;peripheral blood 大肠癌是我国发病率较高的恶性肿瘤之一，其发病率呈逐年升高趋势，其术后复发及远处转移率达20%～45%［1］。因此早期检测出循环癌细胞对判断肿瘤复发和转移及指导临床综合治疗有重要意义［2］。 1 对象与方法 1.1 研究对象 68例大肠癌患者选自2007年1月～2008年3月在我院接受手术治疗并经病理确诊的患者，男39例，女29例，年龄26～88岁，中位年龄65岁。临床分期：Ⅰ期6例，Ⅱ期24例，Ⅲ期27例，Ⅳ期11例。肿瘤分化程度：高分化腺癌26例，中分化28例，低分化11例，未分化3例。对照组3