检测胃癌患者腹腔冲洗液中癌胚抗原mRNA和细胞角蛋白20 mRNA的临床意义

Expression of CEA mRNA and CK-20 mRNA in peritoneal washings of patients with gastric cancer and its clinical significance

目的探讨采用巢式逆转录聚合酶链反应(RT-PCR)检测胃癌患者腹腔冲洗液中癌胚抗原(CEA)mRNA和细胞角蛋白20(CK-20)mRNA的临床价值。方法收集80例胃癌患者和10例胃良性病变患者的腹腔冲洗液或腹水,常规行HE染色细胞学检查,采用巢式RT-PCR方法检测腹腔冲洗液中CEA mRNA和CK-20 mRNA的表达,并以人胃癌细胞株SGC-7901作为阳性对照。结果80例胃癌患者腹腔冲洗液中CEA mRNA的阳性表达率为52.5%(42/80),CK-20 mRNA的阳性表达率为57.5%(46/80),CEA mRNA和CK-20 mRNA的联合检测阳性率为70.0%(56/80),皆高于腹腔冲洗液细胞学(PLC)检查的27.5%(22/80,P<0.05),且22例PLC检查阳性患者的CEA mRNA和CK-20 mRNA检测结果均为阳性。CEA mRNA和CK-20 mRNA的阳性率与淋巴结转移和TNM分期明显相关(P<0.05)。结论巢式RT-PCR检测胃癌患者腹腔冲洗液中CEA和CK-20基因,可以提高腹腔内游离癌细胞(IFCCs)的检测灵敏度和特异度,对于早期诊断胃癌腹膜微转移有一定的临床价值,可为手术方式选择及术中、术后化疗提供依据。

Objective To explore the clinical value of CEA mRNA and CK-20 mRNA expressions in peritoneal washings for gastric cancer.Methods Peritoneal irrigating solution or abdominal dropsy was collected from 80 patients with gastric cancer and 10 patients with benign lesion of stomach.Nested RT-PCR and cytopathological examination were used to determine the CEA mRNA and CK-20 mRNA expressions.Meanwhile,the gastric cancer cell line SGC-7901 served as a positive control.Results Positive expression of CEA mRNA was in 42 patients（52.5%）,of CK-20 mRNA was found in 46 patients（57.5%）,and of CK-20 mRNA and CEA mRNA was in 56 patients（70.0%） by nested RT-PCR.However,positive expression of both CEA mRNA and CK-20 mRNA was found in 22 patients（27.5%）by cytopathological examination.There was a close correlation between CEA mRNA and CK-20 mRNA expressions lymph node metastasis and TNM staging in gastric cancer patients（P0.05）.Conclusions Detecting CEA mRNA and CK-20 mRNA in peritoneaI washings by nested RT-PCR can improve the sensitivity and specificity of intraperitoneal free cancer cells（IFCCs） detection in peritoneal washings,and it is promising as a valuable method for predicting peritoneal metastasis in gastric cancer,then it can provide the basis for therapy.