大肠癌术中门静脉血CK20 mRNA检测临床意义的探讨

Clinical significance of the expression of CK20 mRNA in portal vein blood of patients with colorectal cancer during operation

目的检测大肠癌患者门静脉和外周血中细胞角蛋白(CK20)mRNA,探讨它作为大肠癌肿瘤细胞血行播散标志的临床意义。方法应用逆转录聚合酶链反应(RT-PCR)技术,检测63例大肠癌患者术中抽取的门静脉和外周血中CK20 mRNA和癌胚抗原(CEA)表达的阳性率,并对所测结果进行分析和比较。结果Ducks A,B期和Ducks C,D期患者门静脉血CK20 mRNA阳性表达均明显高于外周血,差异有统计学意义。随着病情进展,门静脉和外周血中CK20 mRNA表达均显著提高(65% vs 96%;33% vs 54%),但仅门静脉结果差异有统计学意义(P<0.005,χ2=8.65)。比较不同时期不同部位CK20 mRNA与CEA表达差异时,除Ducks A,B期患者门静脉血中CK20 mRNA阳性率较CEA阳性率为高且具有统计学意义外,Ducks C,D期门静脉组和各期外周血组中CK20 mRNA阳性率和CEA阳性率差异无统计学意义。结论大肠癌患者门静脉中CK20 mRNA含量高于外周血,门静脉和外周血中CK20 mRNA的阳性表达可随病情进展而增加,因此可作为大肠癌肿瘤细胞血行播散标志,应用于手术后预后判断。

Objective To study the expression and clinical significance of CK20 mRNA in portal vein blood of patients with colorectal carcinoma. Methods CK20 mRNA and CEA were detected in portal vein blood and peripheral blood samples of 63 patients with colorectal cancer during operation by reverse transcription polymerase chain reaction （RT-PCR）. Results The rate of positive expression of CK20 mRNA in portal vein blood of patients with colorectal cancer was obviously higher than that in peripheral blood. The rate of positive expression of CK20 mRNA in portal vein blood and peripheral blood was higher than that of CEA during both A ＋ B and C ＋ D periods, but there was no significant difference. Conclusion The expression level of CK20 mRNA in portal vein blood is higher than in peripheral blood. The expression of CK20 mRNA in portal vein blood and peripheral blood is increased with the progression of cotorectat cancers,so CK20 mRNA can be taken as anindicator of hematogenous dissemination of tumor cells and used to judge the prognosis.