胃癌患者外周血生存素基因检测的临床意义  

Detection of serum survivin in gastric carcinoma patients and its clinical significance

作　　者：孙璟[1] 焦洁茹[1] 魏旭倩[1] 赵雅洁[1] 吴方[1] 江石湖[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院老年病科,200025 [2]上海交通大学医学院附属瑞金医院消化科,200025

出　　处：《国际消化病杂志》2008年第3期246-249,共4页International Journal of Digestive Diseases

基　　金：上海市科委基金资助项目(044119712)

摘　　要：目的检测胃癌患者外周血中生存素(Survivin)基因的表达,并分析其与诊断、转移之间的关系,探讨其作为无创性胃癌诊断和预后检测指标的可能性。方法取52例胃癌患者(转移30例,未转移22例),48例癌前病变患者和50例健康成人的外周血,用实时定量RT-PCR法检测Survivin基因的表达,并分析其与临床病理因素之间的关系。结果正常对照组外周血中未检测到Survivin mRNA表达。48例癌前病变患者中8例被检测到有Survivin mRNA表达,平均拷贝数为1.70±0.75;胃癌组患者Survivin表达检测率为88.46%(46例),平均拷贝数为5.81±1.77,两者有显著差异(P<0.01)。有淋巴结或其他脏器转移者,以及低分化型组的胃癌患者的Survivin表达明显增高(P<0.05)。生存分析表明,Survivin mRNA的高表达者5年生存率(58.33%)显著低于低表达者(89.29%)(P<0.05)。回归分析发现,淋巴结转移、Survivin mRNA的高表达,是影响胃癌预后的独立因素。结论Survivin基因在胃癌患者中存在过表达,并与胃癌预后不良的病理学参数相关,Survivin基因检测可作为临床诊断和评估胃癌患者预后的客观指标之一。采用实时定量RT-PCR检测外周血中Survivin基因的表达,可能是一种较理想的无创性胃癌诊断、转移检测方法。Objective To analyze feasibility of amplifying survivin gene in diagnosis and metastasis detection of gastric cancer. Methods Real-time quantitative reverse transcriptase polymerase chain reaction （RT-PCR） was used respectively to detect the peripheral blood carcinoma gene in normal adults,patients with gastric precancerous lesions and with gastric cancer （metastased group and non-metastased group）. To evaluate the correlation between gene expression and metastasis in gastric cancer. Results In the specimens of normal adults,patients with gastric precancerous lesions and with gastric cancer ,the expression rates of surviving mRNA were 0,20% and 88.46%. The expression of survivin was statistically associated with lymph node involvement and histological grades, Five-year survival rate was lower in patients with higher expression rates, Cox stepwise proportional hazards analysis showed that only and surviving status retained significant independently in prospecting prognosis. Conclusions Survivin gene was overexpressed in gastric cancer. It may be also an important marker of metastasis, RT-PCR can be used to detect metastases of gastric cancer for early diagnosis.

关 键 词：生存素 胃癌 转移 实时定量逆转录聚合酶链反应 

分 类 号：R735.2[医药卫生—肿瘤] R512.62[医药卫生—临床医学]