食管癌患者外周血中CK19mRNA、CYFRA21-1、TPS联合检测的临床意义  

Clinical value of combined detection of CK19 mRNA,CYFRA21-1 and TPS in peripheral blood cells of patients with esophageal carcinoma

作　　者：俞军[1] 周晓明[1] 何晓松[1] 戴美红[1] 

机构地区：[1]江苏省肿瘤医院科研科,江苏省南京市210009

出　　处：《实用老年医学》2009年第6期464-466,469,共4页Practical Geriatrics

基　　金：江苏省科技厅资助项目(BK2001166)

摘　　要：目的评价食管癌患者外周血中微转移基因标记物细胞角蛋白19(CK19)mRNA和细胞角蛋白片段21-1(CYFRA21-1)、组织多肽特异性抗原(TPS)联合测定的临床价值。方法取48例食管癌患者术前外周血标本,应用巢式逆转录聚合酶链反应法(nested-PCR)检测外周血单个核细胞CK19 mRNA的表达,同时采用酶联免疫吸附法(ELISA)测定患者血清CYFRA21-1和TPS水平。结果食管癌患者外周血中CK19 mRNA和血清CYFRA21-1和TPS的阳性检出率分别为52.1%、83.3%和66.7%。联合检测CK19 mRNA、CYFRA21-1和TPS在食管癌患者中的阳性表达,发现其与患者肿瘤细胞分化程度、浸润深度、临床分期及有无淋巴结转移和远处转移等有相关性(P<0.05或P<0.01)。结论在食管癌患者的随访中开展外周血中CK19 mRNA和血清CYFRA21-1和TPS的联合检测可提高食管癌微转移的检出率,以及时监控患者的病情。Objective To investigate the expression of cytokeratin 19 （CK19） mRNA, CYFRA21-1 and TPS in peripheral blood cells of patients with esophageal carcinoma and evaluate its clinical significance. Methods Peripheral blood nucleated cells of 48 patients with esophageal carcinoma were studied by nest-RT-PCR to detect the expression of CK19mRNA, meanwhile, ELISA assay was used to detect the expression of CYFRA21-1 and tissue polypepitde specific antigen （TPS） in serum. Results The positive rate of CKI9 mRNA, CYFRA21-1 and TPS in patients with esophageal carcinoma was 52. 1% ,83.3% and 66. 7% respectively. There was significant difference in the expression of CK19 mRNA, CYFRA21-1 and TPS between patients with different differentiation grade, invasive depth, clinical staging ,lymphatic metastasis and distant metastasis. Conclusions Combined detection of the expression of CK19 mRNA. CYFRA21-1 and TPS in peripheral blood nucleated ceils increases the sensitivity of detecting hematogenous dissemination of cancer cells. Long term survival analysis and more specimens would be helpful for evaluating its clinical significance.

关 键 词：食管癌 细胞角蛋白19 细胞角蛋白片段21—1 组织多肽特异性抗原 巢式逆转录聚合酶链反应 酶联免疫吸附法 

分 类 号：R542.2[医药卫生—心血管疾病]