大肠癌患者外周血中微转移化疗疗效的相关因素

Chemotherapeutic failure in micrometastasis in peripheral blood of patients with colorectal carcinomas

目的探讨大肠癌患者外周血微转移化疗疗效的相关因素及临床意义。方法观察大肠癌患者术后化疗前后外周血微转移的变化。结果７２例患者术前外周血中查出细胞角蛋白２０（ＣＫ２０）阳性表达４２例，阳性率５８３％。术后３天内外周血ＣＫ２０阳性检出较术前多出５例，术后早期短程化疗结束后２２例转阴。化疗后外周血微转移未转阴者与肿瘤组织ｂｃｌ２表达、ｐ５３突变密切相关。结论术后早期短程化疗对控制大肠癌微转移具有一定的作用。研究大肠癌患者外周血微转移对化疗的反应及其与相关基因的关系，有助于指导辅助治疗药物的选择和治疗方案的确定，可作为临床个体化治疗的重要参考。

Objective To study chemotherapeutic failure in the micrometastasis in peripheral blood of patients with colorectal carcinomas and its clinical significance. MethodsZWe investigated the changes of micrometastasis in peripheral blood of patients with colorectal carcinomas before and after chemotherapy.ZResults The positive rate of CK2O mRNA in peripheral blood was 583%. Five more positive cases were detected 3 days after operation than before operation. After early shortterm chemotherapy following operation, 22 cases turned to be negative. The maintaince of micrometastasis in peripheral blood after chemotherapy was significantly related to bcl2 expression and p53 mutation in cancer tissues. Conclusions The early shortterm chemotherapy after operation plays a role in controlling the micrometastasis of colorectal carcinoma. The study of chemotherapeutic effect on micrometastasis in peripheral blood and its relation with the related genes may contribute to the selection of drugs and plans of adjuvant treatment.