联合检测大肠癌组织中血管内皮生长因子与门静脉血细胞角蛋白20 mRNA的临床意义

Clinical significance of the expression of cytokeratin 20 mRNA in portal vein and vascular endothelial growth factor in patients with colorectal cancer

目的探讨大肠癌病人肿瘤组织血管内皮生长因子(VEGF)蛋白和门静脉血细胞角蛋白20(cytokeratin,CK20)mRNA作为血行播散标志物的临床意义。方法RT-PCR技术检测63例大肠癌病人门静脉血CK20mRNA表达阳性率,免疫组织化学方法检测肿瘤标本VEGF蛋白的表达。结果随着病情由DukesA、B期向DukesC、D期进展,门静脉血CK20mRNA表达的阳性率由64.9%升高到96.2%(P<0.01)。高、中分化肿瘤组织VEGF蛋白阳性率为50.0%,低、未分化时升高到92.3%(P<0.01)。CK20mRNA与VEGF作为单项指标测定时,阳性率分别为77.8%和58.7%,联合检测时阳性率显著升高(92.1%)。结论大肠癌病人门静脉血中CK20mRNA和肿瘤组织VEGF作为衡量大肠癌浸润能力的指标,二者表达分别与Dukes分期和肿瘤恶性程度的关系密切。联合检测二者时,敏感性显著提高,可弥补单项指标检测的不足,值得在临床上推广。

Objective To study the expression and clinical significance of cytokeratin（CK） 20 mRNA and VEGF protein in carcinoma tissues of patients with colorectal carcinoma. Methods CK20 mRNA was detected by reverse transcription（RT）-PCR in portal vein blood samples of 63 patients with colorectal cancer, and the expression of VEGF protein by immuneohistochemistry in carcinoma tissues. Results The positive rate of CK20 mRNA in portal vein of Dukes C,D stages were significantly higher than that in Dukes A, B stages（96. 2% vs 64. 9 %）, and the expression rate of VEGF protein in high- and middle-, and low- and non-differentiated carcinoma tissues was 50. 0 %, and 92. 3% respectively（P〈0. 01）. The sensitivity rate of single detection of CK20 mRNA and VEGF protein was 77. 8% and 58. 7% respectively, but that of combined detection was 92. 1%. Conclusion The detection of CK20 mRNA in portal vein blood and VEGF protein in carcinoma tissues is helpful to the judgment of prognosis. The tumor is inclined to liver or distant metastasis in the patients with the positive expression of CK20 mRNA and VEGF protein. The combined detection of CK20 mRNA and VEGF protein is a useful measurement for colorectal cancer, and is helpful for the evaluation of sensitivity.