实时荧光定量RT-PCR检测胸、腹腔积液中癌胚抗原mRNA表达的临床意义

Clinical significance of CEA mRNA detection in pleural and peritoneal effusions by real-time fluorescent quantitative RT-PCR

目的 探讨良、恶性胸腔腹腔积液中癌胚抗原 (CEA)mRNA表达的临床意义。 方法收集明确病理学诊断的恶性肿瘤 (5 8例 )及良性疾病患者 (76例 )的胸腔、腹腔积液 ,采用实时荧光定量RT PCR法检测其CEAmRNA的表达水平 ,并与脱落细胞学检查结果比较。 结果 5 8例肿瘤患者胸、腹腔积液中 ,脱落细胞学检查有 19例 (32 8% )找到癌细胞 ,而CEAmRNA阳性 (>1CN)者为 4 6例 (79 3% ) ,二者阳性率差异具有极显著性意义 (χ2 =2 1 82 ,P =0 0 0 0 )。 76例良性疾病患者的胸、腹腔积液中CEAmRNA阳性 (>1CN)者为 19例 (2 5 0 % ) ,良性疾病与恶性肿瘤患者胸腔腹腔积液中CEAmRNA的表达水平差异有极显著性意义 (χ2 =38 85 ,P =0 0 0 0 )。 结论 采用实时荧光定量RT PCR法可定量检测胸、腹腔积液中CEAmRNA表达 ,其敏感性优于脱落细胞学检查 ,且有助于胸、腹腔积液良、恶性的鉴别。

ObjectivesTo detect CEA mRNA levels in benign and malignant pleural and peritoneal effusions and evaluate their clinical significance.MethodsSamples of pleural and peritoneal effusions from 58 patients with malignant diseases and 76 patients with benign diseases were collected and total RNAs were prepared and subjected to real-time fluorescent quantitative RT-PCR to determine the CEA mRNA levels in these samples. The positive rate of this examination was compared with that of shed cell pathological examination.ResultsNineteen samples (32.8%) of pleural and peritoneal effusions from the 58 patients with malignant diseases showed positive results in shed cell examination, while the number of CEA mRNA >1 CN was 46(79.3%)(χ 2=21.81, P =0.000). Nineteen samples of pleural and peritoneal effusions from the 76 patients with benign diseases showed CEA mRNA >1 CN(25.0%), which was significantly different from that of the patients with malignant diseases (χ 2=38.85, P =0.000).ConclusionCEA mRNA levels in pleural and peritoneal effusions can be quantified by real-time fluorescent quantitative PCR, which is more sensitive than shed cell pathological examination. This technique is helpful in discrimination of benign and malignant pleural and peritoneal effusions.