肝脏血流灌注指数和血小板衍生内皮细胞生长因子在结直肠癌肝转移中的作用研究

The role of PD-ECGF and DPI in hepatic metastasis of patients with colorectal carcinoma

目的检测结直肠癌患者的肝脏血流灌注指数(DPI)和血小板衍生内皮细胞生长因子(PD-ECGF)的表达,探讨结直肠癌肝转移患者DPI及PD-ECGF变化的规律。方法选取术前结直肠癌患者50例作为结直肠癌组(分为肝转移组22例与无肝转移组28例),以同期50例健康人作为对照组。对全体受试对象进行彩色多普勒超声检测肝脏血流状况,并由计算机计算出DPI(肝动脉血流量/全肝血流量)。应用荧光实时定量PCR及免疫组化方法检测术后结直肠癌及癌旁组织标本的PD-ECGFmRNA转录水平和蛋白表达水平。结果病理及影像学资料结果证明结直肠癌肝转移组的DPI值明显高于无肝转移组和对照组(P<0.05),准确率达100%;无肝转移组与对照组之间差异无统计学意义(P>0.05)。免疫组化及荧光实时定量PCR结果证实结直肠癌中PD-ECGFmR-NA及蛋白表达水平明显高于癌旁组织(P<0.05);肝转移组明显高于无肝转移组(P<0.05)。结论 DPI和PD-ECGF可作为检测结直肠癌肝转移的指标,并为结直肠癌肝转移患者的早期诊断和术后随访提供简便、有效的手段。

Objective To investigate the changes in Doppler perfusion index（DPI）of the liver and the platelet derived-endothelial cell growth factor（PD-ECGF）in patients with liver metastasis from colorectal carcinoma by determination DPI and PD-ECGF mRNA and protein expression levels.Methods One hundred patients were enrolled,including 50colorectal carcinoma patients（22of whom with liver metastasis and 28patients without liver metastasis）and 50healthy subjects as control.For all the objects involved,hepatic perfusion was documented with color Doppler flow imaging,and the DPI（hepatic arterial/total liver blood supply）was computed.The expression levels of protein and mRNA of PD-ECGF in 50specimens of carcinoma and adjacent tissues of colorectal carcinoma were assayed by immunohistochemistry and real-time fluorescence quantitative PCR methods in patients with colorectal carcinoma.Results According to pathology and imaging results,the DPI of colorectal carcinoma patients with liver metastasis was significantly higher than that in healthy control group and non-liver metastasis group（P0.05）,with an accuracy rate of 100%.No significant difference in DPI was found between non-liver metastasis group and control group（P0.05）.According to the results of immunohistochemistry and real-time fluorescence quantitative PCR,the expression levels of PD-ECGF protein and mRNA were significantly higher in colorectal carcinoma than that in adjacent tissues（P0.05）;PD-ECGF expression level in colorectal carcinoma patients with liver metastasis was significantly higher than that in non-liver metastasis group（P0.05）.Conclusion DPI and PD-ECGF may be used as monitoring indexes to screen hepatic metastasis in patients with colorectal cancer and as a measure to identify liver metastasis in postoperative follow-up.