肠癌患者外周血中肿瘤标志物联合检测的临床研究  

Clinical research on detecting multimarker genes in peripheral blood of patients with colorectal carcinoma and its clinical signifi cance

作　　者：吴方[1] 魏旭倩[2] 孙璟[1] 楼谷音[1] 王学锋[2] 焦洁茹[1] 

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

出　　处：《中国癌症杂志》2009年第5期353-357,共5页China Oncology

基　　金：上海市科委基金项目(项目编号:044119712)

摘　　要：背景与目的:肠癌患者的生存期与是否存在转移密切相关,外周血中肿瘤标志物的检测有助于对肿瘤发生转移的判断,但单个检测指标尚难于判断。本实验旨在研究多种肿瘤标志物与肠癌患者生存期的关系,并评估其同时检测的临床应用价值。方法:采用实时定量反转录聚合酶链反应(Real-time RT-PCR)方法联合检测92例肠癌、68例肠癌前病变及50例正常对照者外周血生存素(survivin)、癌胚抗原(CEA)、细胞角蛋白20(CK20)基因的转录,并分析其与临床病理因素及预后关系。结果:正常对照组外周血中未检测到CEA、CK20及survivin mRNA的转录;良性病变患者survivin转录的检测阳性率为7.35%,平均拷贝数为(2.5±0.9)。肠癌外周血CEA、CK20、survivin mRNA转录的阳性率分别为41.3%、47.8%、72.8%,其阳性率与疾病的分期、淋巴结转移等相关。survivin mRNA高转录者4年生存率显著低于低转录者。肠癌患者外周血CEA、CK20、survivin mRNA转录的联合检测对肿瘤预后判断具有较高的特异性和阳性似然比。结论:Real-time RT-PCR联合检测肠癌外周血中多个肿瘤标志物基因的表达,是一种较为理想的监测肿瘤复发、判断预后的方法。Background and purpose： Lifespan of patients with colorectal carcinoma is closely related to tumor metastasis. The detection of tumor marker may be a useful tool to observe recurrence. However, the roles of biomarkers for patients with colorectal cancer have not been fully defined. In our study, we explored the relationship between multiple tumor markers and colorectal carcinoma in order to clarify its clinical significance. Methods： Levels of circulating CEA, CK20 and survivin mRNA expression from 92 patients with colorectal carcinoma, 68 patients with non-cancerous lesions and 50 normal control were detected by reverse transcription real time polymerase chain reaction （RT-PCR） and the data was analyzed combined with their clinical data. Results： There was no CEA, CK20 or survivin mRNA detected in peripheral blood of normal adults, while survivin mRNA expression rate in patients with non-cancerous lesions was 7.35%, the average copy number was 2.5±0.9. In patients with colorectal carcinoma, the expression rates of CEA, CK20 and survivin mRNA were 41.3%, 47.8% and 79.3%, respectively, the results were statistically associated with lymph node involvement or distant metastasis and Dukes stage of the disease. Four-year survival rate was lower in patients with higher survivin mRNA expression. The combination of detecting CEA, CK20 and survivin mRNA expression in colorectal carcinoma patients had higher specificity and positive likelihood ratio topredict prognosis. Conclusion： The combination of detecting multiple tumor mRNA markers by Real-time RT-PCR may be a useful tool to observe recurrence and predict the prognosis of patient with colorectal carcinoma.

关 键 词：肠癌 肿瘤标志物 实时定量反转录聚合酶链反应 转移 预后 

分 类 号：R730.43[医药卫生—肿瘤] R735.3[医药卫生—临床医学]