结肠癌病人手术前后血中CK-20 mRNA检测的临床意义

Detection of CK-20 mRNA in peripheral blood in patients-with colon cancer before and after operation

目的探讨结肠癌病人手术前后外周血中CK-20 mRNA水平变化的情况,从而判断肿瘤微转移情况。方法采用逆转录多聚酶链式反应方法(RT-PCR方法),以CK-20 mRNA为靶基因,检测了38例结肠癌病人手术前后CK-20mRNA表达情况。结果结肠良性疾病组CK-20 mRNA表达均为阴性。结肠癌组(38例)术前CK-20 mRNA阳性率为23.7%(9/38),术后阳性率为37%(14/38),术后明显高于术前(P<0.05)。A组(术中先结扎回流静脉及切断相应系膜)术前术后阳性率为30%(6/20),B组(不结扎回流静脉及不切断相应系膜)术前阳性率为35%(7/20),术后阳性率为50%(19/20),B组术后阳性率明显高于术前(P<0.05)。结论结肠癌病人(B期、C期)术前已有部分病人血中存在游离癌细胞,手术中的牵拉刺激可能增加癌细胞扩散的可能性,术中先结扎回流静脉及切断相应系膜可起到阻止癌细胞血行播散的可能性。

Objective To explore the importance of CK-20 mRNA detection in peripheral blood in patients with colon cancer before and after opomtion,in order to determine tumor miemmetastasis.Methods We detected CK-20 mRNA level in peripheral blood in 38 patients with colon cancer by RT-PCR before and after operation. Results CK-20 mRNA could not be detected in benign colon disese group. The positive rate was 23.7 % in colon cancer group （38 cases） be.for operation and the positive rate was 37 % after operation. Post-oporative rate was significant higher than preoperative rate （ P 〈 0.05）. The positive rate of post-oporation and pre-oporation in A group （ligated drainage veins and cut the mesentery at first） was 30% ,and in B group （not ligated drainage veins and not cut the mesentery at first） was 35% before operation and was 50% after operation. There was significant difference between pre-oporation and post-oporation. Conclusion There was some free cancer cells in the peripheral blood of some patients with colon cancer before operation. To pull and stimulate tumor in the operation may impole cancer cells dissemination. Ligated drainge veins and cut the mesentery at first may provent cancer cell dissemination in the peripheral blood.