大肠癌患者外周血CEAmRNA、HNP1-3的检测及临床意义  

Detection of CEA mRNA and HNP1 - 3 in peripheral blood of patients with colorectal cancer and its clinical significance

作　　者：王妍华[1] 肖菊香[1] 侯银银[1] 王乐[1] 魏晓晖[1] 邢雯[1] 

机构地区：[1]西安交通大学医学院第一附属医院,陕西西安710061

出　　处：《现代肿瘤医学》2012年第3期561-565,共5页Journal of Modern Oncology

基　　金：西安市科技计划项目基金资助(编号:GG06182)

摘　　要：目的:研究大肠癌患者外周血中CEAmRNA、HNP1-3的表达及临床意义。方法:采用NestedRT-PCR法检测外周血CEAmRNA、ELISA法检测血清HNP1-3在大肠癌患者术前组、术后组及正常对照组中的表达。结果:外周血CEAmRNA在大肠癌患者术前组、术后组及正常对照组的阳性率分别为54%、34%、5%,术前组和术后组相比存在显著差异(P=0.044),二者与正常对照组比较,有统计学差异(P<0.001、P=0.012);CEAmRNA与患者性别、年龄、肿瘤部位及分化程度无关,但与Dukes'分期、淋巴结转移有关;外周血CEAmRNA对大肠癌的诊断敏感性和特异性分别为54%、95%。大肠癌患者术前组血清HNP1-3浓度中位数为20.33ng/ml,正常对照组7.69ng/ml,术后组14.35ng/ml;术前组、术后组血清HNP1-3水平均明显高于正常对照组,差异有统计学意义(P<0.001、P=0.005);并且血清HNP1-3水平也与Dukes'分期、淋巴结转移有关;血清HNP1-3对大肠癌的诊断敏感性、特异性分别为62%、95%。联合检测外周血CEAmRNA与血清HNP1-3的敏感性(72%)及特异性(100%)均高于单一指标。结论:大肠癌患者外周血中CEAmRNA表达较正常对照组明显增高,且与Dukes'分期、淋巴结转移密切相关。HNP1-3在大肠癌患者血清中呈高表达,且具有较高的敏感性及特异性,有望成为一种新的大肠癌肿瘤标志物。联合检测外周血CEAmRNA表达及血清HNP1-3水平可提高检测敏感性和特异性,对发现大肠癌微转移可能有重要的临床意义。Objective：To investigate the expression and clinical significance of CEAmRNA and HNP1-3 in peripheral blood of patients with colorectal cancer（CRC）.Methods：CEAmRNA and HNP1-3 were detected in peripheral blood of CRC patients before,after operation and healthy volunteers by nested RT-PCR and ELISA technique.Results：The positive rates of CEAmRNA in preoperative,postoperative periods of CRC patients and normal controls were 54%,34% and 5% respectively.Significant difference was observed between preoperative and postoperative periods（P = 0.044）,which were both higher than normal controls（P 0.001,P = 0.012）;For CEA mRNA,it was not significantly correlated with patients＇ age,gender,sites and differentiation,however,with the increase of CRC Dukes＇ stage and metastases of lymph nodes,the positive rate of CEA mRNA was elevated;The sensitivity and specificity of CEAmRNA for CRC were 54% and 95% respectively.The serum concentration of HNP1-3 of CRC patients before operation and after operation were 20.33ng / ml vs 14.35ng / ml,which were both higher than normal controls（7.69ng / ml）（P 0.001,P = 0.005）.There was statistical significance between different Dukes＇ stages and metastases of lymph nodes.The sensitivity and specificity of HNP1-3 were 62% and 95% respectively.Combined assay of CEAmRNA and HNP1-3,the diagnostic sensitivity（72%） and specificity（100%） of CRC were improved.Conclusion：In peripheral blood of CRC patients,the expression of CEA mRNA was higher than normal controls and after operation.It was significantly associated with Dukes＇stage and lymph nodes metastases.The high serum concentration of HNP1-3 in CRC patients was significantly associated with Dukes＇stage and lymph nodes metastases.It may be a tumor marker for CRC with good sensitivity and specificity.Combined detecting the expression of CEAmRNA in peripheral blood and serum HNP1-3 may improve the sensitivity and specificity,which may be probably beneficial for detecting micrometastasis of CRC.

关 键 词：外周血 微转移 CEAMRNA HNP1-3 大肠癌 肿瘤标志物 

分 类 号：R735.34[医药卫生—肿瘤]