大肠癌患者外周血循环癌细胞检测的临床意义

Clinical significance of detecting the circulating cancer cells in peripheral blood from colorectal cancer

目的 探讨肠癌外周血循环癌细胞检测的临床意义。方法 以ＣＫ－２０ｍＲＮＡ为靶分子，ＲＴ－ＰＣＲ技术检测３种癌细胞株（结脾性腺癌株ＷＳ－４８０、胃癌细胞株ＳＧＣ－７９０１、食管癌细胞株ＴＥ－１１）和６７例大肠癌患者外周血细胞ＣＫ－２０ｍＲＮＡ的表达。结果 三种癌细胞株中，只有结肠癌细胞表达ＣＫ－２０ｍＲＮＡ，ＲＴ－ＰＣＲ技术能检出１０＾７个单核细胞中的一个肿瘤细胞，６７例患者中。

AIM To evaluate the clinical significance of circulating cancer cells in the peripheral blood of patients with colorectal cancer.METHODS Peripheral blood from 67 patients with colorectal cancer and three of cancer cell lines (colonic-cancer cell Line SW-480, gastric-cancer cell line and esophageal cancer cell line TE-11) were analysed for CK-20 mRNA using RT-PCR.RESULTS CK-20 mRNA could be detected only in colorectal cancer cell line. The lower limit of detection was 1 to 10 CK-20 mRNA positive cells in 1×107 blood mononuclear cells. CK-20 mRNA was positive in 35 of the 67 patients with colorectal cancer. The positive rate was correlated with disease stages: 25% in Dukes'A, 38.46% in Dukes' B, 55.17% in Dukes'C, and 70.59% in Dukes D. In 53 surgically treated patients there was a significant increase in positive rate postoperatively (30 verus 25), and in 25 patients receiving chemotherapy after operation, 2 was positive after chemotherapy as compared with 6 before chemotherapy.CONCLUSION Detection of CK-20 mRNA in peripheral blood may serve as a useful objective parameter for the staging metastais. recurrence and therapeutic moinitoring of the colorectal cancer.