细胞角蛋白20和生存素基因在老年结肠癌患者外周血中的表达及其意义  

Expressions of Cytokeratin 20 and Survivin in Peripheral Blood in Elderly Patients with Colorectal Carcinoma and Their Significance

作　　者：何清[1] 焦洁茹[1] 魏旭倩[1] 赵雅洁[1] 吴方[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,上海市200025

出　　处：《中国全科医学》2010年第18期1969-1972,共4页Chinese General Practice

摘　　要：目的检测老年结肠癌患者外周血中细胞角蛋白20(CK20)和生存素(survivin)基因的表达,探讨二者与肿瘤诊断、转移的关系。方法选取老年结肠癌患者72例、癌前病变者54例及正常对照者42例,用实时定量反转录聚合酶链反应(Real-time RT-PCR)检测CK20和生存素基因的转录,并分析二者与临床病理因素之间的关系。结果正常对照组外周血中未检测到CK20和生存素mRNA的转录;癌前病变者外周血生存素mRNA的转录率为7.4%(4/42),平均拷贝数为(2.22±0.86);结肠癌患者外周血CK20和生存素mRNA转录率分别为47.2%(34/72)和73.6%(53/72),二者的转录量与Dukes分期及淋巴结转移有关。生存素mRNA高转录者5年生存率(58.6%)显著低于低转录者(90.7%),差异有统计学意义(P<0.01)。回归分析发现,生存素的表达、淋巴结转移及Dukes分期是影响患者预后的独立因素。结论 CK20 mRNA和生存素mRNA在老年结肠癌患者中过表达,可作为诊断微转移和评估预后的客观指标。Objective To detect the expressions of Cytokeratin 20（CK20） and survivin gene in peripheral blood of elderly patients with colorectal carcinoma to find out their relationship to cancer diagnoses and metastasis.Methods CK20 and survivin gene transcriptions were determined by real-time quantitative reverse transcription polymerase chain reaction（real-time RT-PCR） and their relationship to clinicopathological factors was analyzed in 72 elderly with colorectal carcinoma,54 with precancerosis and 42 normal controls.Results CK20 and survivin mRNA transcriptions were not detected out in peripheral blood of normal controls.The peripheral survivin mRNA transcription rate of precancerosis patients was 7.4%（4/42）,the average copy number was 2.22±0.86.CK20 and survivin mRNA transcription rates of colorectal carcinoma patients were 47.2%（34/72）,73.6%（53/72）,respectively,and their transcript levels were related to Dukes staging and lymphatic metastasis.The 5-year survival rate was significantly lower in patients with high survivin mRNA transcription（58.6%） than in those with low（90.7%）（P0.01）.Regression analysis showed that survivin expression,lymph node metastasis and Dukes staging were independent prognostic factors influencing patients′ prognosis.Conclusion The overexpressions of CK20 mRNA and survivin mRNA can be used as objective indicators for micro-metastasis diagnosis and prognostic evaluation in elderly patients with colorectal carcinoma.

关 键 词：结肠肿瘤 细胞角蛋白20 生存素 实时定量反转录聚合酶链反应 

分 类 号：R735.35[医药卫生—肿瘤]