胃癌患者门静脉血中p53和K-ras基因突变的检测及其临床意义

目的 检测胃癌患者门静脉血中p53和K-ras基因突变,探讨其与胃癌肝转移的关系.方法 应用PCR-SSCP技术检测62例胃癌手术患者门静脉血中p53和K-ras基因的突变率.结果 外周血和门静脉血中的p53和K-ras突变阳性率分别为8%、5%和39%、34%;有无肝转移p53和K-ras突变阳性率分别为92%、77%和24%、22%;剖腹后探查前或胃癌探查后门静脉血p53和K-ras突变阳性率分别为39%、34%和56%、63%,上述两组指标之间相比差异均有统计学意义（P＜0.05）,但与患者性别、年龄、肿瘤的分化程度之间无显著性相关（P＞0.05）.结论 门静脉血内微转移癌细胞的基因突变检测有助于判断胃癌临床分期,对预测胃癌肝内微小转移有一定的临床价值.

Detection of p53 and K-ras gene mutation in portal venous blood of gastric carcinoma patients

Objective To investigate the relations between p53 and K-ras gene mutation in portal venous blood of gastric carcinoma patients and cancer metastasis. Methods p53 and K-ras gene mutation was detected with PCR-SSCP technology in 62 cases of gastric carcinoma. Results p53 and K-ras mutation rate were 39% and 34% in portal venous blood, but only 8% and 4. 8% in peripheral blood; The rate of gene mutation in p53 and K-ras were 24% and 22% in patient without liver metastasis, 92% and 77% in patient with liver metastasis; The rate of gene mutation in p53 and K-ras in portal venous were 39% and 34% before surgical exploration, but 56% and 63% after exploration. The rate of positive detection of the mutation was significantly (P<0.05) correlated to blood sampled from different sites, surgical exploration and liver metastasis. Conclusion Gene mutation of cancer cell micrometastasis in portal venous blood is related with clinical staging of gastric carcinoma and hence a good predictor of micrometastasis in the liver.