结直肠癌患者外周血人端粒酶逆转录酶mRNA和MUC1 mRNA的检测及其临床意义

Detection of Peripheral Blood Human Telomerase Reverse Transcriptase mRNA and MUC1 mRNA in Patients with Colorectal Cancer and its Clinical Significance

背景:传统影像学检查和血清肿瘤标记物检测对结直肠癌微转移的诊断价值有限。目的:检测结直肠癌患者外周血人端粒酶逆转录酶(hTERT)mRNA和MUC1 mRNA表达,探讨两者对结直肠癌微转移的诊断价值。方法:收集53例结直肠癌患者和21名健康人的外周血标本,以实时荧光定量逆转录聚合酶链反应(RT-PCR)检测hTERT mRNA和MUC1 mRNA表达,分析两者表达与肿瘤临床病理特征的关系。应用接受者操作特征曲线(ROC曲线)分析hTERT mRNA、MUC1 mRNA和两者联合检测对结直肠癌的诊断价值。结果:结直肠癌组外周血hTERT mRNA和MUC1 mRNA表达率和表达水平显著高于正常对照组(P<0.05),两者表达与肿瘤淋巴结转移、血行转移和TNM分期相关(P<0.05)。hTERT mRNA、MUC1 mRNA和两者联合检测诊断结直肠癌的ROC曲线下面积分别为0.806、0.778和0.861,诊断界值为Ct<32。结论:外周血hTERT mRNA和MUC1 mRNA可作为诊断结直肠癌微转移的标记物,以实时荧光定量RT-PCR联合检测两项指标优于单项检测。

Background： Conventional radiological techniques and serum tumor markers have limited value for diagnosing micrometastasis of colorectal cancer （CRC）. Aims： To detect the expressions of peripheral blood human telomerase reverse transcriptase （hTERT） mRNA and MUC1 mRNA in CRC patients, and to evaluate their value for the diagnosis of of CRC. Methods： Blood samples of 53 CRC patients and 21 healthy subjects were collected. Real-time fluorescent quantitative reverse transcriptase polymerase chain reaction （RT-PCR） was used to determine the expressions of peripheral blood hTERT mRNA and MUC1 mRNA. Correlations between their expressions and clinicopathologic characteristics of CRC were analyzed. Receiver operating characteristic curve （ROC curve） was used to evaluate the diagnostic value of hTERT mRNA, MUC1 mRNA and their combination for CRC. Results： The positivity rates and expression levels of peripheral blood hTERT mRNA and MUC1 mRNA in CRC patients were significantly higher than those in healthy controls （P〈0.05）, and their expressions were correlated with lymph node metastasis, hematogenous metastasis and TNM staging of CRC （P〈0.05）. ＇ The area under ROC curve of hTERT mRNA, MUC1 mRNA and their combination in diagnosing CRC was 0.806, 0.778 and 0.861, respectively, the cutoff value was Ct〈32. Conclusions： Peripheral blood hTERT mRNA and MUC1 mRNA are novel and excellent markers for diagnosing CRC. Combined detection of these two markers by real-time fluorescent quantitative RT-PCR is superior to detection of a single one.