大肠癌骨髓微转移检测的临床意义

Clinical significance of the detection of micrometastasis in bone marrow of colorectal carcinoma

目的 探讨大肠癌骨髓微转移的临床意义。方法 运用SP免疫组织化学法 (IHC) ,联用细胞角蛋白 (CK)、膜上皮抗原 (EMA)、癌胚抗原 (CEA)三种单克隆抗体检测 61例大肠癌骨髓血标本。结果 大肠癌骨髓微转移阳性率为 39 3 %。DukesB期和C期阳性率均显著高于A期 (P均 <0 0 1 ) ,低分化和粘液腺癌组显著高于高分化和中分化腺癌组 (P均 <0 0 5)。结论 大肠癌临床分期越晚和分化程度越低 ,越易发生骨髓微转移。恶性肿瘤病人定期复查骨髓微转移 ,能动态监测病情 ,评估病人预后 ,为进一步辅助治疗提供依据 ,是一种简便易行的。

Objective To evaluate the clinical significance of micrometastasis in bone marrow of colorectal carcinoma.Methods A SP immunohistochemical staining technique was undertaken for detection the expression of CK, EMA and CEA in 61 bone marrows of colorectal carcinomas.Results The positive rate of micrometastasis in bone marrows of colorectal carcinoma was 39.3%, those in Dukes B and C stage were significantly higher than that in A stage( P <0 01) and that in poorly differentiated and mucinous adenocarcinoma group was significantly higher than those in highly and moderately differentiated groups( P <0 05).ConclusionThe results suggested that the later the clinical stage of colorectal carcinoma was and the lower the differentiation was, the easier the micrometastasis formed. Periodical detection of micrometastasis in bone marrow of malignant carcinomas which could control condition actively, may evaluate the prognosis of patients, provide basis for further adjuvant therapy and was considered to be an easily handled method which had clinical value.