胃癌患者术后化疗前后检测外周血细胞角蛋白20mRNA的临床意义  

Expression of CK20 mRNA in the peripheral blood around postoperative chemotherapy in patients with gastric cancer and its clinical significance

作　　者：乔建梁[1] 孟兴凯[1] 张俊晶[1] 齐力[1] 梁越[1] 孙娟[2] 

机构地区：[1]内蒙古医学院附属医院普通外科,呼和浩特010050 [2]内蒙古医学院附属人民医院变态反应科

出　　处：《中华胃肠外科杂志》2009年第1期32-35,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：内蒙古自治区高等学校科学研究项目（NJZY07089）

摘　　要：目的探讨将外周血细胞角蛋白20（CK20mRNA）动态变化作为临床评估胃癌化疗敏感性分子学指标的可行性。方法对31例胃癌术后行辅助化疗（FOLFOX4）患者．运用荧光定量RT—PCR检测化疗前后各时点外周血中CK20mRNA的表达．选取15位健康志愿者为阴性对照组。结果化疗前1周时检测，有25例（80．6％）胃癌患者表达CK20mRNA，6例（19．4％）始终不表达；其中16例（51．6％）升高，9例降低（29．0％）；CK20mRNA表达量为2．22±2．12。化疗开始时检测，CK20mRNA表达量已升高至2．96±2．27，两个时间点检测结果比较，t=2．10．P〈0．05，差异有统计学意义。化疗1周期后检测，有24例（77.4％）胃癌患者表达CK20mRNA．7例（22．6％）升高．17例（54．8％）降低，7例（22．6％）不表达；表达量为2．05±1．86，与化疗开始时的检测结果比较t=2．50，P〈0．05，差异有统计学意义。化疗前后CK20mRNA表达率比较，差异有统计学意义（χ^2=6．06，P〈0．05）。结论化疗可使外周血中CK20mRNA表达水平明显降低．动态定量检测化疗前后外周血中CK20mRNA可能成为评估胃癌术后化疗敏感性的重要指标。Objective To investigate whether CK20 mRNA expression level could be considered as an effective molecular indicator for evaluation of chemotherapy sensitivity. Methods All samples of peripheral blood were taken from 31 gastric cancer patients undergone radical operation a week before postoperative chemotherapy, at the first day of chemotherapy point, and after the first cycle of chemotherapy resepectively, and subjected to FQ RT-PCR assay for CK20 mRNA. The chemotherapy scheme was FOLFOX 4. The control group was 15 healthy volunteers. Results Aomng the 31 gastric cancer patients, the value of CK20 mRNA before postoperative chemotherapy was increased （2.96±2.27 vs 2.22±2.12, t=2.10, P〈0.05） in 25 positive cases, and then declined after chemotherapy（2.05±1.86 vs 2.96±2.27, t=2.50,P〈0.05） in 24 positive cases. The expression level of CK20 mRNA in patients before chemotherapy was increased in 16 cases （51.6%）, declined in 9 cases （29.0%） and stabilized as negative in 6 cases （19.4%）. After chemotherapy the level of CK20 mRNA was increased in 7 cases（22.6%）, declined in 17 cases （54.8%） and stabilized as negative in 7 cases （22.6%）, there was significant difference between the two groups （χ^2=6.06, P〈0.05）. Conclusions The expression level of CK20 mRNA in the peripheral blood detected by FQ RT-PCR in patients with gastric cancer declines after postoperative adjuvant chemotherapy. Different individuals have different sensitivity to chemotherapeutics. Dynamic monitoring CK20 mRNA should be considered as an effective index to evaluate the efficacy of postoperative adjuvant chemotherapy.

关 键 词：胃肿瘤 细胞角蛋白20 荧光定量及转录聚合酶链反应 肿瘤化疗 

分 类 号：R735[医药卫生—肿瘤]