胃肠道恶性肿瘤患者外周血微转移诊断及预后研究  

Study on micrometastasis and prognosis in peripheral blood of patients with gastrointestinal carcinomas

作　　者：刘新兰[1] 陈萍[1] 李云霞[1] 师新荣[2] 

机构地区：[1]宁夏医科大学附属医院肿瘤内科,银川750004 [2]宁夏医科大学附属医院肛肠外科,750004

出　　处：《临床肿瘤学杂志》2009年第6期500-504,共5页Chinese Clinical Oncology

基　　金：宁夏回族自治区卫生厅科技重点计划项目(W2004026)

摘　　要：目的:检测胃肠道恶性肿瘤患者外周血中细胞角蛋白20(CK20)mRNA和人端粒酶逆转录酶(hTERT)mRNA的表达,探讨其能否作为判断胃肠道恶性肿瘤患者外周血微转移及预后的分子生物学指标。方法:采用RT-PCR技术检测72例胃肠道恶性肿瘤患者、30例肠道良性病变患者和30例健康体检者外周血中CK20 mRNA和hTERT mRNA的定性和半定量表达。以人胃腺癌细胞株SGC-7901作阳性对照。结果:(1)CK20 mRNA和hTERT mRNA在胃肠道恶性肿瘤患者外周血中的阳性率分别为51.40%和61.10%,相对系数分别为0.84±0.18和0.82±0.17;在肠道良性病变患者外周血中阳性率分别为6.67%和3.33%,相对系数分别为0.12±0.01和0.11;在健康体检者外周血中阳性率及相对系数均为0。胃肠道恶性肿瘤患者与胃肠道良性病变患者、健康体检者相比,CK20 mRNA和hTERT mRNA的表达均有统计学差异(P<0.01)。(2)RT-PCR法联合检测胃肠道恶性肿瘤患者外周血中CK20 mRNA和hTERT mRNA微转移的灵敏度为72.22%～83.33%,特异度为68.57%～85.71%,准确度为73.58%～81.13%。(3)CK20 mRNA、hTERT mRNA阳性者根治术后复发转移率高于阴性者,生存率低于阴性者(P<0.05)。(4)CK20 mRNA与hTERT mRNA在胃肠道恶性肿瘤患者外周血中的表达呈正相关(P<0.01)。结论:胃肠道恶性肿瘤患者外周血中存在CK20 mRNA和hTERT mRNA的表达,两项指标联合检测可作为诊断胃肠道恶性肿瘤患者外周血微转移和判断预后的预测指标。Objective ：To detect the expression of CK20 mRNA and hTERT mRNA in peripheral blood of patients with gastrointestinal carcinomas, discuss whether they can be used as molecular biological markers fnr predicting mierometastasis in peripheral blood and evaluating prognosis. Methods： Peripheral blood of 72 patients with gastrointestinal carcinomas, 30 benign gastrointestinal lesions, and 30 healthy examination cases were detected by RT-PCR technique for qualitative and semi-quantitative analysis of CK20 mRNA and hTERT mRNA. Results： （ 1 ） The positive rate of CK20 mRNA and hTERT mRNA in patients with gastrointestinal carcinomas was 51.40% and 61.10% , relative coefficient was 0. 84 ±0. 18 and 0. 82 ±0. 17; 6. 67% and 3.33% in benign gastrointestinal lesions, relative coefficient was 0. 12 ± 0. 01 and 0.11. The two markers were not detected in healthy examination cases. Comparison to the expressions of them among gastrointestinal carcinomas, benign gastrointestinal lesions and healthy examination cases, there were all significant differences（ P 〈 0. 01 ）. （2） The expression of CK20 mRNA and hTERT mRNA which were detected by RT-PCR technique diagnose micrometastasis in peripheral blood of gastrointestinal carcinoma patients with sensitivity of 72.22% -83.33%, specificity of 68.57%-85.71% , accuracy of 73.58%-81.13%. （3） The gastrointestinal carcinoma patients who had radical resection with positive expression have higher recurrence or metastasis rates, and lower survival rates compared with negative expression patients（P 〈0. 05）. （4） The positive rates and relative coefficients of CK20 mRNA were positively con＇elated with hTERT mRNA in peripheral blood of patients with gastrointestinal carcinomas（P 〈0. 01 ）. Conclusion： CK20 mRNA and hTERT mRNA were positive expressed in gastrointestinal carcinoma patients. The two markers can be used as molecular biological markers for predicting micrometastasis in peripheral blood and evaluating prognosis.

关 键 词：胃肠道恶性肿瘤 外周血 微转移 RT-PCR 细胞角蛋白20 人端粒酶逆转录酶 

分 类 号：R735.2[医药卫生—肿瘤] R735.3[医药卫生—临床医学]