胃肠道癌外周血CEA-mRNA的表达及临床意义

CEA-mRNA expression in peripheral blood of patients with gastrointestinal carcinoma and its clinical significance

目的 通过检测手术前、后胃肠道癌患者外周血癌胚抗原信使核糖核酸 (CEA mRNA)的表达 ,了解胃肠道癌血行播散转移情况及在围手术期综合治疗中的意义。方法 采用巢式逆转录 聚合酶链式反应 (Nest RT PCR)检测 6 2例胃肠道癌患者和 2 2例对照组外周血CEA mRNA的表达状况。结果 6 2例癌患者样本中 ,术前 2 7例 (43.5 % )外周血CEA mRNA检测阳性 ,术后 2 6例阳性 (41.9% ) ,对照组 10例正常人及 12例良性胃肠病患者CEA mRNA测定均为阴性。Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者外周血CEA mRNA阳性率依次为 37.5 %、2 7.3%、5 1.9%、80 .0 % ,各期间无显著性差异 (P >0 .0 5 )。Ⅰ +Ⅱ期与Ⅲ +Ⅳ期合并 ,两组患者间CEA mRNA的表达有显著性差异 (P <0 .0 5 )。胃肠道癌的分化程度及癌栓的形成与外周血CEA mRNA的表达无关。 35例伴局部淋巴结转移的患者的外周血CEA mRNA阳性率 (6 2 .9% )与 2 7例无淋巴结转移患者的阳性率 (18.5 % )有显著性差异 (P <0 .0 1)。手术前后外周血CEA mRNA阳性率差异无显著性 (P >0 .0 5 )。结论 外周血CEA mRNA检测可作为胃肠道癌复发、转移及预后的判断指标 ,对临床正确分期及综合治疗起指导作用。外周血CEA mRNA表达阳性的患者 ,应在围手术期辅以免疫治疗和 /或全身化疗 ,以遏止肿瘤复发、?

ObjectiveTo investigate the hematogenous micrometastatic status of the patients with gastrointestinal carcinoma, and the significance of CEA mRNA expression in peripheral blood, as a predictive marker for metastasis and recurrence. MethodsPeripheral blood were collected before and two weeks after operation from 62 patients and 22 controls (12 cases with benign gastrointestinal disease,10 normal volunteers).CEA-mRNA expression in blood was detected by nested reverse transcriptase(RT) polymerase chain reaction (PCR).Pathologic examination was done by conventional method. ResultsOf 62 cancer patients, 27 (43.5%) gave positive CEA-mRNA expression before operation, and so did 26(41.9%) postoperatively, but none in those controls. In stage Ⅰ-Ⅳ, CEA-mRNA positive rate was 37.5%, 27.3%, 51.9% and 80.0% respectively, between them P>0.05. But between stage Ⅰ+Ⅱ and Ⅲ+Ⅳ,the difference was significant (P<0.05). In 35 patients with local lymph node metastasis, 62.9%(22 /35) were positive for CEA-mRNA; in the 27 patients without lymph node metastasis,18.5%(5 /27) gave positive CEA-mRNA(P<0.01). The CEA-mRNA expression was not correlated with the differentiation of tumour cells and cancer embolus. There was no significant difference in CEA-mRNA expression before and after operation(P>0.05). ConclusionCEA-mRNA may be a sensitive marker for detecting subclinical metastasis, recurrence and prognosis for gastrointestinal carcinoma.