消化道肿瘤患者外周血癌胚抗原mRNA水平监测与患者预后的关系研究

Correlation between the level of CEA mRNA expression in peripheral blood and prognosis of patients with malignant digestive tumor

目的动态监测消化道恶性肿瘤患者外周血癌胚抗原(CEA)mRNA表达的水平变化,分析其与患者临床分期及预后的关系。方法在治疗前,治疗后6个月及1年采用实时荧光定量逆转录聚合酶链反应(RT-PCR)检测97例初治的消化道肿瘤患者外周血CEA mRNA的水平变化。结果97例消化道恶性肿瘤患者外周血CEA mRNA的表达阳性率为73.2%,对照组未见表达;病理分期Ⅲ、Ⅳ期患者外周血CEA mRNA的阳性比率和含量都明显高于Ⅰ、Ⅱ期患者(P<0.05);不同治疗阶段患者外周血CEA mRNA水平和患者病情、治疗效果及预后密切相关。结论荧光定量RT-PCR检测消化道恶性肿瘤患者外周血CEA mRNA的表达具有敏感性、特异性,对消化道恶性肿瘤的辅助诊断、治疗方案选择、疗效判断、有无转移和预后有着重要的临床价值。

Objective To monitor the expression level of CEA mRNA in peripheral blood in patients with malignant digestive tumor, and analyze its relationship with the clinical stages and prognosis of patients. Methods The real-time reverse transcription polymerase chain reaction （RT-PCR） assay was used to detect the expression of CEA mRNA in peripheral blood of 97 patients with malignant digestive tumor and 49 control individuals. Results The positive rate of CEA mRNA expression in patients with gastrointestinal malignant tumor was 73.2% （71/97） , and no expression was found in 49 control individuals. The copy number of CEA mRNA expressi（m significantly enhanced in patients with metastasis, and decreased in patients after treatment （P 〈 0. 05）. Conclusion The real-time RT-PCR is a sensitive and specific assay for detecting the expression of CEA mRNA in patients with malignant digestive tumor. It may be used to predict early metastasis, which possesses clinical significance in assessing the prognosis and therapeutie schedule.