大肠癌患者淋巴结CK20mRNA与血清CD4^+、CD8^+表达关系的研究  

The correlation between lymph node CK20mRNA and blood serum CD4^+,CD8^+ expression in colorectal cancer patients

作　　者：曾霓[1] 冯国丽[2] 文坤明[2] 曾庆良[2] 

机构地区：[1]遵义医学院 [2]遵义医学院附属医院胃肠外科,贵州遵义563000

出　　处：《遵义医学院学报》2010年第4期339-343,共5页Journal of Zunyi Medical University

基　　金：院资金(学生项目);H-008

摘　　要：目的研究结直肠癌患者淋巴结中细胞角蛋白20(cytokertain 20,CK-20)mRNA的表达及外周血中CD4+、CD8+细胞比值与NK细胞活性的表达,探讨两者之间的关系。方法采用常规HE染色病理切片检测21例结直肠癌患者281枚淋巴结中转移癌灶以及采用逆转录聚合酶链反应(reverse transcription polymerase chain reaction,RT-PCR)方法检测患者淋巴结中CK-20mRNA的表达;采用流式细胞仪检测患者外周血CD4+、CD8+、CD4+/CD8+的表达。结果 HE染色和RT-PCR CK-20mRNA方法检测淋巴结转移率分别为10%(2/21)和48%(10/21),两者比较差异有统计学意义(χ2=10,P<0.05);两种方法检测淋巴结转移度分别为5.7%(16/281)和49.8%(140/281),两者比较差异有统计学意义(χ2=17.087,P<0.05);RT-PCR CK-20mRNA方法检测的淋巴结转移度在DukesA、DukesB、DukesC期的表达分别为0﹪(0/10)、44.59﹪(103/231)9、2.5﹪(37/40),各期间差异有统计学意义(P<0.05)。患者血清CD4+、CD4+/CD8+低于健康对照组,CD8+高于健康对照组(P<0.05);将结直肠癌患者肠系膜淋巴结CK-20mRNA有无阳性表达(即有无转移)重新进行Dukes分期(即Dukes A’、B’和C’期)后发现:A’、B’期患者血清CD4+、CD4+/CD8+高于C’期(P<0.05);A’期患者血清CD8+低于C’期(P<0.05),且新Dukes分期与血清CD4+呈负相关(r=-0.497,P<0.01);与CD4+/CD8+呈负相关(r=-0.714,P<0.01);与CD8+呈正相关(r=0.945,P<0.01)。结论 RT-PCR方法检测淋巴结CK20mRNA的表达判定淋巴结微转移明显优于常规HE染色病理切片法;微转移的检出率随着结直肠癌患者Dukes分期增高而增高;结直肠癌患者术前免疫功能随患者Dukes分期增高而明显低下,且有淋巴结微转移患者免疫功能明显低于无转移患者。结直肠癌患者免疫功能越低下或抑制,淋巴结微转移发生率越高。Objective To determine the expresstion and significance of CD4＋,CD8＋ in peripheral blood and CK-20 in regional lymph nodes of colorectal cancer; and to determine the relationship between expression of CD4＋,CD8＋ with lymph node micrometastasis in eolorectal cancer to look for a reliable indicator in detection of lymph node microtastasis. Methods Detect the expression of CD4＋,CD8＋ in peripheral blood of 21 celorectal cancer patients by flow cytometry ; detect the expression of CK-20 in lymph node by reverse transcription-polymerase chain reaction; detect the lymph node metastatic by conventional patholo^ca] ;and analyze their relationship with Dukes stage. Results For metastatic ratio of lymph nodes in the 21 colorectal cancer patients ,it was 10% （2/21）by conventional pathological test and it was 48% （10/21）in the method which checked CK20mRNA by real time-Polymerase chain reaction （RT-PCR）.There existed statistical significance in their difference（ X^2=-10, P〈0.05）. For metastatic degree of lymph nodes detected by the two methods were respectively 5.7% （16/281）and 49.8% （140/281）, there also existed statistical significance in their difference （X^2=17.087 ,P〈0.05）. The metastatic degree of lymph nodes detected by CK20mRNA by BT-PCR in Dukes A, Dukes B and Dukes C was respectively 0 % （0/10）,44.59 % （103/231） and 92.5 % （37140）,and the differences had statistical significance between each two stages （P〈0.05）. The positive expression rate of serum CD4＋ and CD4＋/CD8＋ in peripheral blood of 21 eoloreetal cancer patients were lower than the control significantly, and the expression rate of CD8＋ was higher than the control （P〈0.05）. If we regard positive expresstion of CK-20mRNA as metastases in lymph nodes in the coloreetal cancer patients, we can get new Dukes stages（Dukes A＇, B＇ and C＇ stage）. Then the expression rate of CD4＋ and CD4＋/CD8＋ of eolorectal cancer patients in Dukes A＇, B＇ ,were higher than Dukes C＇ signific

关 键 词：结直肠癌 淋巴结微转移 CK-20 RT-PCR T淋巴细胞亚群 

分 类 号：R730.53[医药卫生—肿瘤]