循环肿瘤细胞p53基因表达和端粒酶活性在大肠癌临床病理学中的意义

Clinicopathological Significance of p53 Gene Expression and Telomerase Activity in Circulating Tumor Cells of Patients with Colorectal Carcinoma

背景与目的:探讨大肠癌患者循环肿瘤细胞p53基因的表达和端粒酶活性的变化及其临床病理学意义。材料与方法:113例大肠癌患者、13例良性大肠肿瘤患者术前的外周血和28例健康供血员的外周血,用分层液分离含有循环肿瘤细胞的单个核细胞,应用流式细胞仪和TRAP-ELISA法,分别检测p53基因表达和端粒酶活性。结果:在105例有信息的大肠癌患者中,p53基因表达和端粒酶活性的阳性率分别为74.3%(78/105)和61.0%(64/105)。异常的p53基因表达和端粒酶活性水平均与大肠癌患者的淋巴结转移显著相关(P<0.05),两者的联合检测提高了对大肠癌淋巴结转移的预测水平。p53基因异常表达还与大肠癌细胞分化程度显著相关(P=0.003)。结论:循环肿瘤细胞异常的p53基因表达和端粒酶活性是大肠癌的恶性生物学标志,两者密切相关,联合检测可提高对淋巴结转移状态的预测水平。

BACKGROUND AND AIM：To study the clinicopathological significance of p53 gene expression and telomerase activity in circulating tumor cells of patients with colorectal carcinoma.MATERIALS AND METHODS：Mononuclear cells containing circulating tumor cells were isolated by Ficoll-Hypaque gradient centrifugation in peripheral blood from 113 preoperative patients with colorecatal carcinomas,13 patients with benign colorectal disease,and 28 healthy volunteers.FCM and TRAP-ELASA were used to evaluate p53 gene expression and telomerase activity,respectively.Experimental data were analyzed by SPSS 11.0 software and χ2 test.RESULTS：Among 105 informative patients with colorectal carcinoma,positive rate of p53 expression and telomerse activity were 74.3%（78/105）and 61.0%（64/105）,respectively.Aberrant expression levels of both p53 gene and telomerase in patients with colorectal cancer were significantly correlated with lymph node metastasis（P〈0.05）and their simultaneous measurement could raise the prediction accuracy of metastasis.Expression of p53 gene was also significantly correlated with differentiation degree of colorectal carcinoma（P=0.003）.CONCLUSION：Aberrant p53 gene expression and telomerase activity in circulating tumor cells might be malignant biomarkers.Both were closely related and could predict nodal involvement.