结肠癌患者实时荧光定量RT-PCR检测门静脉血CK19 mRNA水平及其临床意义  

Expression and Significance of Cytokeratin 19 and 20 Detected by Real-Time Fluorescence Quantitative RT-PCR in Colon Neoplasms

作　　者：高阳[1] 庄竟[1] 刘永刚[1] 张勇超[1] 

机构地区：[1]河南省肿瘤医院普外科,河南郑州450008

出　　处：《中国误诊学杂志》2008年第32期7815-7817,共3页Chinese Journal of Misdiagnostics

摘　　要：目的:探讨细胞角蛋白19(Cytokeratin 19,CK19)mRNA在结肠癌术中患者门脉血中的表达及临床意义。方法:采用逆转录聚合酶链反应(RT-PCR)半定量检测CK19mRNA在结肠癌手术中患者门脉血中的表达,随访并记录术后24个月时患者的生存情况。结果:90例结肠癌患者门脉血CK19 mRNA阳性者62例,阳性率为66.7%;结肠癌组织CK19 mRNA的表达与分化程度、Dukes分期有相关性(分别rs=0.280,P=0.008;rs=0.367,P<0.001),且两者之间分别存在线性趋势(精确概率法分别P=0.011;P<0.001);CK19 mRNA在肝转移患者中的表达水平明显高于无肝转移组(P=0.049),并且门脉血CK19 mRNA与肝转移间具有一定相关性(rs=0.208,P=0.049)。术中发现肝转移且门脉血CK19 mRNA阳性表达的患者3例,而术中无肝转移但门脉血CK19 mRNA阳性表达的患者59例,其中9例在随访期间出现肝转移,其阳性率分别为4.8%(3/62)和15.3%(9/59)。结论:门脉血CK19 mRNA的表达与结肠癌的分期及分化程度有关,对判断肝脏微转移提供一定的帮助。Objective：To explore the expression and significance of Cytokeratin 19（CK19） and Cytokeratin 20 （CK20） in portal venous blood of colon cancer. Methods：The expression of CK19 and 20 in portal venous blood of 90 specimens in colon cancer was detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction （RT-PCR） in the process of surgery. The survival rates in 90 patients with colon cancer were recorded in followup for 24 months. Results：66.7% （62/90） of the patients with colon cancer showed CK19 mRNA positive expression in portal venous blood. With the progress with grades and Dukes stages ,the expression level of CK19 mRNA was increased respectively （ Exact Text,P = 0. 011 ;P〈0. 001 ）;and when compared with those not having live metastasis, the expression of CK19 mRNA in liver metastasis of colon cancer was higher （P=0. 049）;in the case of patients with positive expression of CK19 mRNA in portal venous blood,the positive rate of the liver metastasis and having not liver metastasis was 4.8% （3/62） and 15.3% （9/59） respectively in the follow-up for 24 months. And the positive rate of the liver metastasis and having not liver metastasis was 4.9%（2/41） and 17.9%（7/39） respectively in the combination group in the follow-up for 24 months. Conclusion：The expression level with CK19 mRNA combined with CK19 mRNA detecting in portal venous blood is detected by real-time fluorescence quantitative RT-PCR for patients with colon cancer during operation,which is related to the grades and Dukes stages of colon cancer ,may judge the micrometastasis of liver.

关 键 词：结肠肿瘤/病理学/血液 聚合酶链反应/3法 角蛋白/血液/遗传学 RNA 信使 门静脉 人类 

分 类 号：R735.35[医药卫生—肿瘤]