VEGF和CK20mRNA联合检测在大肠癌病人中的意义

Clinical significance of the expression of CK20mRNA and VEGF in patients with colorectal cancer

目的探讨大肠癌病人外周血细胞角蛋白(CK20 mRNA)和肿瘤组织VEGF蛋白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)技术和免疫组织化学方法检测63例大肠癌术中抽取的外周血CK20 mRNA和手术切除肿瘤组织中VEGF蛋白的表达,并对所测结果进行分析和比较。结果高、中分化和低、未分化大肠癌病人的CK20 mRNA和VEGF的阳性率分别为30.0%、50.0%和84.6%、92.3%,均有非常显著性差异(P<0.01)。DukesA、B期和C、D期大肠癌病人CK20 mRNA和VEGF的阳性率分别为32.4%、56.8%和53.8%、61.6%,无显著性差异(P>0.05)。CK20 mRNA与VEGF作为单项指标测定的阳性率分别为41.3%和58.3%,联合检测时阳性率升至69.8%,有非常显著性差异(P<0.01)。结论大肠癌病人外周血CK20 mRNA和肿瘤组织VEGF可作为衡量术后复发转移的有效指标;两者联合检测时,敏感性显著提高。

Objective To study the expression and clinical significance of CK20 mRNA in peripheral blood and VEGF in carcinoma tissues of patients with colorectal carcinoma. Methods CK20 mRNA was detected by reverse transcription polymerase chain reaction（RT-PCR）in peripheral blood samples of 63 patients with colorectal cancer during operation. And the expression of VEGF was investigated by immunohistochemical assay. Results The positive rate of CK20 mRNA in the peripheral blood and VEGF protein expression in the tumor tissue were closely related to the tumor pathologic classification, and there was significant difference between the high and mid-differentiated group and the low and un-differentiated group（30. 0% vs 84. 6% and 50. 0% vs 92. 3%, respectively,P〈0. 01）. There was no significant difference in the positive rate of CK20 mRNA and VEGF in the patients between Dukes A ＋ B to Dukes C＋ D stage. As the single indicator of the patients with colorectal cancer, the positive rate of CK20 mRNA and VEGF was 41.3% and 58. 3% respectively,but on the combined detection,the positive rate was 69. 8%（P〈0. 01）. Conelusion The detection of CK20 mRNA in peripheral blood and VEGF in carcinoma tissues is helpful to the judgment of prognosis. The combined detection of CK20 mRNA and VEGF is an useful measurement for colorectal cancer, and is helpful for the evaluation of sensitivity.