胃癌患者外周血细胞角蛋白20mRNA的检测及临床意义

Detection of Cytokeratin 20 mRNA in Peripheral Blood of Patients with Advanced Gastric Cancer and Its Clinical Implication

目的 采用逆转录聚合酶链反应检测进展期胃癌患者外周血中细胞角蛋白 2 0 (cytokeratin 2 0 ,CK2 0 )mRNA的表达 ,以检测胃癌外周血循环中微转移的情况 ,并比较CK2 0mRNA的阳性检出率与胃癌患者的性别、年龄、肿瘤部位和胃癌组织的分化程度的关系。方法 6 0例胃癌患者和 2 0例慢性胃炎患者分别作为试验组和对照组。采用密度梯度离心法分离获取全部病例外周静脉血中的单个核细胞 ,随后应用逆转录聚合酶链反应的方法检测其中的CK2 0mRNA表达情况。结果 试验组中有 32例患者外周血循环中有阳性表达 ,阳性率为 5 3.3% ;而在对照组患者外周血中无 1例标本检出细胞角蛋白 2 0mRNA ;两组间的阳性率差异具有显著性 (P <0 .0 0 5 ) ;癌细胞的检出率与胃癌组织的分化程度呈正相关 (P <0 .0 5 ) ,而与胃癌患者的性别、年龄和肿瘤部位等因素无明显相关 (P >0 .0 5 )。结论 CK2 0mRNA可作为标志物用于检测胃癌的血行转移 ;CK2 0mRNA的阳性检出率与胃癌组织的分化程度具有相关性。

Objective To study the detection of micrometa st asis in peripheral blood circulation of patients with advanced gastric neoplasm and its clinical implication and to compare the outcome with the gender,age of the patients,the focus and the differentiation of the neoplasm.Methods 60 advanced gastric cancer patients and 20 chroni c gastritis patients were selected.Mononuclear cells in peripheral blood isolate d from 60 cases of advanced gastric cancer patients were isolated by Ficoll dens ity gradient centrifugation and RT-PCR was used to detect the CK20 mRNA of thes e cells.Results 32 of 60 gastric cancer patients had CK20 mRNA ex pression,while there was no CK20 mRNA detected from all the peripheral blood sa mples of patients suffered from chronic gastritis.The positive rate of CK20 mRNA in peripheral blood was 53.3%.The positive detection was significantly correlat ed with the pathological classification of primary focus. Conclusion CK20 mRNA can be used as a tumor marker to det ect micrometastasis through peripheral blood circulation of gastric cancer. The positive rate of CK20 mRNA in peripheral blood circulation is correlated with th e pathological classification of primary focus.