食管癌放疗前后外周血癌胚抗原mRNA与蛋白检测的对比研究

Comparative analysis of CEA mRNA and protein detection in peripheral blood of esophageal cancer patients treated with radiotherapy

目的:研究食管癌放疗前后外周血癌胚抗原(carcinogenic embryonic antigen,CEA)mRNA与蛋白的表达及其临床意义。方法:收集72例食管鳞状细胞癌(ESCC)患者根治性放疗前后外周血,应用巢式RT-PCR检测CEA mRNA的表达,放免法检测血清CEA蛋白的表达,分析其与临床病理特征及放疗疗效的关系。结果:放疗前CEA mRNA阳性者与CEA蛋白升高者分别占47.2%(34/72)与22.2%(16/72),CEA mRNA的诊断效能显著优于CEA蛋白。并且,放疗前CEA mRNA阳性与淋巴结转移相关(P=0.046),而CEA蛋白升高与食管癌临床病理特征无关。放疗后CEAmRNA与蛋白表达变化均与放疗疗效有关(P=0.034、0.037)。结论:如检测方法得以改进,食管癌外周血CEA mRNA有望成为替代血清CEA蛋白的有效分子标记。

Objective： To study the clinical significance of carcinogenic embryonic antigen （CEA） mRNA and protein expres- sion in peripheral blood of esophageal cancer patients treated with radiotherapy. Methods： CEA mRNA expression was determined by nest RT-PCR and serum CEA protein was determined by immunoassay in pre- and post-radiotherapy blood of 72 esophageal cancer patients, their associations with clinicopathological features and radiotherapy response were further evaluated. Results： The positive expression of CEA mRNA and serum protein in pre-radiotherapy were 47.2% （34/72） and 22.2% （16/72） respectively, the diagnostic value of CEA mRNA was superior to the serum CEA protein. Furthermore, CEA mRNA expression was associated with lymph metastasis in pre-radiotherapy （P=0.046）, whereas serum CEA level was not as- sociated with clinicopathological featuresL Both of the alteration of CEA mRNA and serum CEA protein was associated with radiotherapy response （P=-0.034, 0.037）. Conclusion： If the detection method can be improved in the future, CEA mRNA ex- pression in peripheral blood maybe a promise biomarker which can replace the serum CEA protein in esophageal cancer.