外周血和门静脉血人端粒酶反转录酶mRNA的定量检测与结直肠癌肝转移及预后的关系  

Relationship of quantitative detection of human telomerase reverse transcriptase mRNA in peripheral and portal vein blood to liver metastasis and prognosis in colorectal cancer

作　　者：刘少平[1] 聂磊[2] 胡亚华[1] 张险峰[1] 胡晓岚[1] 方春华[1] 

机构地区：[1]黄石市中心医院消化科,湖北省435000 [2]湖北省肿瘤医院腹部外科

出　　处：《中华消化杂志》2015年第4期225-230,共6页Chinese Journal of Digestion

基　　金：湖北省自然科学基金（2010CDB07401）

摘　　要：目的 探讨结直肠癌患者外周血和门静脉血的人端粒酶反转录酶（hTERT） mRNA的表达与其肝转移及预后的关系.方法 纳入2009年1月至2011年4月确诊并行根治性手术治疗的原发性结直肠癌患者181例.应用荧光定量PCR法检测所有患者术前外周血和术中门静脉血的hTERT mRNA相对表达量.所有患者术后随访3年.分别比较同时性肝转移（18例）和无同时性肝转移（163例）患者,以及异时性肝转移（29例）和无异时性肝转移（152例）患者的术前外周血和术中门静脉血hTERT mRNA的相对表达量;分析术中门静脉血hTERT mRNA相对表达量与结直肠癌患者临床病理特征的关系;均采用t检验.对结直肠癌患者异时性肝转移风险进行单因素和多因素分析.采用Log-rank法比较术中门静脉血hTERT mRNA高表达组与低表达组的术后生存率.结果 同时性肝转移患者术前外周血和术中门静脉血hTERT mRNA的相对表达量分别为8.04＆#177;3.79和11.88＆#177;4.19,无同时性肝转移患者术前外周血和术中门静脉血hTERT mRNA的相对表达量分别为4.30＆#177;2.81和4.94＆#177;3.37,前者均高于后者（t=5.159,8.084;P均＜0.01）;异时性肝转移患者术前外周血和术中门静脉血hTERT mRNA相对表达量分别为7.16＆#177;3.08和9.83＆#177;2.96,无异时性肝转移患者术前外周血和术中门静脉血hTERT mRNA相对表达量分别为4.11＆#177;2.58和4.56＆#177;3.09,前者均高于后者（t=5.648,8.467;P均＜0.01）.结直肠癌患者术中门静脉血hTERT mRNA的表达在不同肿瘤分化程度、不同肿瘤大小、不同肿瘤浸润深度、有否淋巴结转移、有否术后复发、不同术后生存期患者中差异均有统计学意义（t=2.987,2.281,2.135,5.070,5.431,6.803;P均＜0.05）.单因素分析显示,术前外周血和术中门静脉血hTERT mRNA表达均与异时性肝转移相关（χ2=9.522,16.393;P均＜0.01）;Cox多因素回归分析显示,以上两者均是其独立危险因Objective To investigate the correlation of the expression of human telomerase reverse transcriptase （hTERT） mRNA in peripheral and portal vein blood to liver metastasis and prognosis of patients with colorectal cancer （CRC）.Methods From January 2009 to April 2011,a total of 181 patients diagnosed as primary CRC and received radical resection were enrolled.The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood were detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction （RT-PCR）.All the patients were followed up for three years after operation.The relative quantitative expression of hTERT mRNA in peripheral blood before operation and intraoperative portal vein blood were compared between patients with synchronous liver metastasis （18 cases） and without synchronous liver metastasis （163 cases）; between metachronous liver metastases （29 cases） and without metachronous liver metastases （152 cases）.The relationship between the expression of hTERT mRNA in intraoperative portal vein blood and clinicopathological features of patients with CRC was analyzed.The t-test was used.Univariate and Multivariate Cox analysis were used for risk analysis of metachronous liver metastases.Log-rank test was used for comparisons of survival rate between the group with high hTERT mRNA expression in intraoperative portal vein blood during operation and the group with low expression.Results The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood in synchronous liver metastases group （8.04±3.79 and 11.88±4.19） was higher than that of no synchronous liver metastases group （4.30±2.81 and 4.94±3.37,t=5.159 and 8.084; both P〈0.01）.The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood in metachronous liver metastases group （7.16±3.08 and 9.83 ± 2.96） was higher th

关 键 词：结直肠肿瘤 门静脉血 端粒 末端转移酶 RNA 信使 肝转移 预后 

分 类 号：R735.34[医药卫生—肿瘤]