腹腔化疗前后腹腔积液中癌胚抗原mRNA和端粒酶活性的变化及意义

Change and Clinical Significance on the Detection of Carcinoembryonic Antigen mRNA and Telomerase Activity in Ascites before and after Intraperitoneal Chemotherapy

目的了解监测腹腔积液中癌胚抗原mRNA（CEAmRNA）和端粒酶活性（TA）用于诊断腹腔转移癌、评价腹腔化疗疗效及预后的临床价值。方法应用反转录套式聚合酶链反应技术和端粒末端重复序列扩增-杂交-酶联免疫技术检测腹腔积液中CEAmRNA和TA，分析腹腔转移癌患者腹腔化疗前后腹腔积液中CEAmRNA和TA结果的变化与预后的关系。结果腹腔转移癌腹腔积液中CEAmRNA和TA的阳性结果（59／68和56／68）显著高于良性腹腔积液患者（3／33和2／33）（P〈0．01），其阳性率也显著高于CEA和细胞学检测结果（P〈0．01）；化疗有效者的阳性结果（9／37和10／37）明显低于化疗无效者（28／31和28／31）（P〈0．01），且化疗后CEAmRNA和TA阳性者6-18mo的生存人数显著低于指标阴性者（P〈0．01，P〈0．05）。结论检测腹腔化疗前后腹腔积液中cEAmRNA和TA对协助诊断腹腔转移癌、评价腹腔化疗疗效及判断预后都有较高的应用价值。

Objective To understand the clinical value on the detection of carcinoembryonic antigen mRNA （CEA mRNA） and telomerase activity （TA） in ascites for the diagnosis of abdominal metastasis carcinoma, the appraisement of drug therapy into abdominal cavity and the evaluation of the prognosis of the patients with abdominal metastasis carcinoma. Methods CEA mRNA and TA were detected by reverse transcriptase-nested primers-polymerase chain reaction and telomeroc re- peat amplification protocol-hybridism-enzyme-linked immunosorbent assay in ascites. To analyse the relation in the change of CEA mRNA and TA in ascites before and after the drug therapy into abdominal cavity and the prognosis in the cases of abdominal metastasis carcinoma. Results The positive results of CEA mRNA and TA in the carcinoma group （59/68 and 56/68） were much higher than the benign ascites group （3/33 and 2/33） （P〈0. 01）. The positive rates of CEA mRNA and TA were much higher than CEA and cytology （P〈0. 01）. The positive results of the carcinoma group which had a good effect of chemotherapy （9/37 and 10/37） were much lower than the cases of which had no effect of chemotherapy （28/31 and 28/31） （P〈0. 01） and the number of 6 to 18 months survival cases which had positive results of CEA mRNA and TA after chemotherapy were much lower than that of which having negative results （P〈0. 01 , P〈0. 05）. Conclusion It has high value that detecting CEA mRNA and TA in the ascites dynamically on the assisted diagnosis of abdominal metastasis carcinoma and judging the chemotherapy effect and its prognosis.