CK20 mRNA联合组织切片检测直肠癌系膜内转移的临床研究  

The Clinical Study of the Metastasis of Mesorectum by the Detection of CK20 mRNA Combined with Tissue Slice

作　　者：朱胜昌[1] 赖斌[1] 朱培谦[2] 

机构地区：[1]南昌大学研究生院医学部,2006级南昌330006 [2]南昌大学第二附属医院胃肠外科,南昌330006

出　　处：《江西医学院学报》2009年第1期83-86,共4页Acta Academiae Medicinae Jiangxi

摘　　要：目的通过检测直肠癌系膜组织中CK20 mRNA的表达水平,研究直肠癌系膜转移与临床病理特征的关系,探讨直肠癌系膜转移规律,为切除直肠系膜的合理范围提供依据。方法取行直肠癌手术切除的直肠癌和直肠系膜组织标本40例,良性肠道疾病的正常直肠系膜组织10例。剪取肿瘤组织和距肿瘤下缘1、2、3、4、5 cm的直肠系膜组织,分别进行:①各段系膜组织分别HE染色切片检查;②各段系膜组织中CK20 mRNA表达水平检测(RT-PCR法),并结合临床病理资料进行分析。结果40例直肠系膜标本HE染色切片中,距肿瘤下缘1、2、3、4、5 cm的阳性率分别为:37.5%(15/40)、15.0%(6/40)、0%(0/40)、0%(0/40)、0%(0/40);40例直肠系膜标本中,距肿瘤下缘1、2、3、4、5 cm的系膜组织CK20 mRNA阳性表达率分别为:47.5%(19/40)、27.5%(11/40)、12.5%(5/40)、0%(0/40)、0%(0/40)。CK20 mRNA在正常直肠系膜组织中不表达,系膜中CK20 mRNA的表达与肿瘤分期、肿瘤形态及分化程度有关(P<0.05)。结论①检测直肠系膜组织中CK20 mRNA的表达(肿瘤微转移)较常规病理组织学检查方法更为敏感;②对于直肠癌,一个相对比较安全的远端直肠系膜切除长度为4 cm,但对于TNM分期偏晚、浸润型、低分化直肠癌病例,范围应适当增大。Objective To examine expression of CK20 mRNA in the mesorectum of rectal cancer and study the relationship between the metastasis of mesorectum and the clinical pathology characteristic. Explore the transfer rule of rectal cancer mesorectum and provide the reasonable excision basis for radical operation. Methods There were 40 rectal cancer and its corresponding mesorectum tissues which were 1,2,3,4,5 centimeters from tumor tissues after rectal surgery. Ten normal rectal mesorectum were also collected. Then： ①Detected the transfer of cancer cells in mesorectal by HE staining. ②Through RT-PCR method, detected the expression of CK20 mRNA and analyzed its expression according to clinical pathology data. Results In 40 cases of the mesorectum sections by HE staining, the positive rate of mesorectum cases of 1,2,3,4,5 cm from the lower edge of tumor tissues were as the follows：37.5% （15/40）, 15.0% （6/40） , 0% （0/40） and 0% （0/40）, and 0% （0/40） ;The positive expression rate of CK20 mRNA in mesorectum cases of 1,2,3,4,5 cm from the lower edge of tumor tissues were as follows： 47. 50% （19/40）,27.5% （11/40）, 12.5% （5/40）,0% （0/40） and 0% （0/40）. There were no CK20 mRNA expression in normal rectal mesorectal. The expression of CK20 mRNA in mesorectum were significantly related to tumor stages, tumor shape and differentiation（P〈0.05）. Conclusion ①The use of RT-PCR in detecting the expression of CK20mRNA （tumor micro-transfer） is more sensitive than the histopathology method. ②According to the results of rectal cancer, 4cm is the most suitable length of excision in the remote mesorectum. However in the situations, such as TNM staging late, infiltrate type, and poorly differentiated cases, the scope of excision should be enlarged.

关 键 词：CK20 MRNA 逆转录PCR 组织切片 直肠肿瘤 系膜转移 临床研究 

分 类 号：R735.37[医药卫生—肿瘤]