结直肠癌患者血癌胚抗原mRNA检测的临床意义

Clinical Significance of Blood Carcinoembryonic Antigen mRNA Detection in Patients with Colorectal Cancer

背景:结直肠癌预后不佳,进一步研究结直肠癌患者肿瘤标记物的表达及其与肿瘤临床病理特征的关系对指导临床治疗具有重要意义。目的:检测结直肠癌患者的外周血癌胚抗原(CEA)、CEA mRNA以及肿瘤同流静脉血CEAmRNA,探讨血CEA mRNA检测在结直肠癌诊治中的临床意义。方法:以酶联免疫吸附测定(ELISA)检测71例结直肠癌患者的外周血清CEA,同时以巢式逆转录聚合酶链反应(RT-PCR)检测其外周血(71例)和肠系膜上静脉血(35例)CEA mRNA。分析血CEA和CEA mRNA的表达与结直肠癌临床病理特征的关系。结果:结直肠癌患者的外周血CEA mRNA阳性率为69.0％。显著低于肠系膜上静脉血的82.9％(P<0.05),外周血CEA阳性率(45.1％)显著低于CEA mRNA阳性率(P<0.01)Dukes C期和D期结直肠癌患者的外周血CEA和CEA mRNA阳性率显著高于A期和B期患者(P<0.05)。Dukes D期肝转移患者肠系膜上静脉血CEA mRNA阳性率为85.7％(6/7)。结论:检测外周血CEA mRNA有助于结直肠癌患者的预后判断,肿瘤回流静脉血CEA mRNA的检测对结直肠癌肝转移的诊断具有重要意义。

Background： The prognosis of colorectal cancer is poor. To further study the relationship of tumor markers and the clinicopathological characteristics of colorectal cancer is very important in guiding the clinical treatment. Aims： To detect the peripheral blood carcinoembryonic antigen （CEA）, and CEA mRNA in both peripheral blood and tumor venous return blood of patients with colorectal cancer, and to appraise the clinical significance of the latter in the diagnosis and treatment of colorectal cancer. Methods： The peripheral serum CEA in 71 patients with colorectal cancer was detected by enzyme-linked immunosorbent assay （ELISA）; Nested reverse transcriptase polymerase chain reaction （RT-PCR） was used to detect the CEA mRNA in 71 peripheral blood samples and in 35 blood samples from superior mesenteric vein simultaneously. The relationship between the blood CEA, CEA mRNA and the clinicopathological characteristics of colorectal cancer was analyzed. Results： Of the 71 colorectal cancer patients, 49 （69.0%） showed CEA mRNA expression in the peripheral blood samples, the positivity rate was significantly lower than that in the superior mesenteric vein blood samples （82.9%, P〈0.05）; whereas the positivity rate of CEA was relatively lower than that of CEA mRNA in the peripheral blood （45.1% vs. 69.0%, P〈0.01）. The patients in Dukes C and D showed higher positivity rates of peripheral blood CEA and CEA mRNA than those in Dukes A and B （P〈0.05）. The blood samples from superior mesenteric vein in 6 （85.7%） Dukes D patients with liver metastasis were positive for CEA mRNA. Conclusions： Peripheral blood and superior mesenteric venous blood CEA mRNA measurement are helpful in the prediction of prognosis and diagnosis of liver metastasis in patients with colorectal cancer.