实时荧光定量PCR检测结直肠癌外周血hTERT mRNA和MUC1 mRNA的表达及临床意义

Expression and Clinical Significance of hTERT mRNA and MUC1 mRNA in the Peripheral Blood in Patients with Colorectal Cancer Detected by Real-Time Quantitiative RT-PCR

目的消化道恶性肿瘤微转移的诊断一直是临床难题之一,外周血是早期转移阶段肿瘤细胞播散的最主要途径,而选择合适的检测指标尤为重要。本研究旨在应用受试者工作特征曲线(receiver operating characteristiccurre,ROC)分析探讨人外周血端粒酶逆转录酶mRNA(human telomerase reverse transcriptase mRNA,hTERT mRNA)和MUC1 mRNA检测对结直肠癌微转移的诊断价值。方法用实时定量荧光逆转录聚合酶链反应(real-time fluorescentquantitative reverse transcriptase polymerase chain reaction,RT-PCR)方法对53例结直肠癌患者及21例健康体检者外周血标本进行检测,应用受试者ROC对hTERT mRNA、MUC1mRNA检测结果进行分析评价。结果结直肠癌组外周血hTERTmRNA和MUC1 mRNA表达水平(13.99±7.76,43.09±29.98)显著高于正常对照组(0.48±0.39,3.53±4.79),差异具有统计学意义(P均<0.001)。hTERTmRNA表达与肿瘤淋巴结转移、血行转移和TNM分期相关(P=0.024,0.036、0.017)。MUC1mRNA表达与肿瘤淋巴结转移、血行转移和TNM分期相关(P=0.034、0.014、0.011)。结直肠癌患者的hTERTmRNA和MUC1 mRNA在ROC下面积分别为0.91和0.89。hTERT mRNA和MUC1 mRNA对结直肠癌的临床诊断临界点均为Ct≤32。结论通过ROC评价hTERTmRNA和MUC1 mRNA,可作为结直肠癌微转移的诊断标识物。

Objective Micrometastasis in gastrointestinal cancer diagnosis is one of the most difficult problems is one of the most difficult problems. Spreading through peripheral circulation is one of the most important ways for dignosing tumor cells metastasis. It is cirtial to select appropriate detection markers to indicate this phrase. This study explored human telomerase reverse transcriptase mRNA（ hTERT mRNA） and MUC1 mRNA in colorectal cancer micrometastasis diagnosis through receiver operating characteristic curve （ROC） analysis. Methods The peripheral blood samples from 53 cases with colorectal cancer （CRC） and 21 healthy cases were tested,their hTERT mRNA,MUC1 mRNA were detected and analysed by ROC. Results The expression levels of peripheral blood hTERT mRNA and MUC1 mRNA in CRC patients were significantly higher than those in the normal controls（ 13.99 ± 7. 76 vs 0. 48 ± 0. 39, P 〈 0. 001 ; 43.09 ± 28.98 vs 3.53 ± 4. 79, P 〈 0. 001 ）. The expression of hTERT mRNA was associated with lymph node metastasis, hematogenous metastasis and TNM staging of CRC （ P = 0. 024, 0. 036,0. 017 ）. The expression of MUC1 mRNA were correlated with lymph node metastasis ,hematogenous metastasis and TNM staging of CRC（ P =0. 034,0. 014,0. 011 ）. The hTERT mRNA and MUC1 mRNA area under the ROC were 0. 91 and 0. 89 respectively in CRC group. The clinical diagnostic cut-off of hTERT mRNA and MUC1 mRNA in CRC were both Ct≤32. Conclusion hTERT mRNA and MUC1 mRNA from peripheral blood cells could be cousidered as tumor markers for CRC micrometastasis.