大肠癌术后血路播散的动态追踪监测

目的 研究大肠癌血路播散在监测大肠癌患者术后复发转移中的意义。方法 使用靶向ＣＫ２０的ＲＴ－ＰＣＲ技术，对５８例大肠癌患者外周血和骨髓微转移癌细胞在术前和术后不同时间进行了动态检测。结果 术后肿瘤无复发转移的大肠癌患者ＣＫ２０的阳性率（１６.３％）显著低于复发转移者（８８.９％）。血路播散有四种情况：①术后ＣＫ２０检测曾有一度转阴；②ＣＫ２０检测持续阳性；③ＣＫ２０在术后才转阳；④ＣＫ２０术后一直阴性。死亡的６例患者术前ＣＫ２０检测均为阳性。结论 大肠癌血路播散在术后复发转移中起重要作用，动态追踪检测大肠癌ＣＫ２０的变化有助于预测肿瘤的复发转移、术前存在血路播散者预后差。

The detection of postoperative hematogenous dissemination of colorectal cancer

Objective To study the significance of monitoring postoperative hematogenous micrometastasis of colorectal cancer. Methods The micrometastatic cancer cells in peripheral blood and bone marrow of the perioperative patients were investigated by CK20 mRNA RT PCR. Results The positive rates(16 3%) of hematogenous dissemination without relapse or metastasis after operation were significantly lower than that(88 9%) in patients with postoperative relapse or metastasis. There were four types of hematogenous dissemination. (1) Postoperative temporary negatives.(2)Consistant positives. (3) CK 20 turned positive postoperatively. (4) Consistant negatives. All the 6 patients that died had positive CK 20 preoperatively. Conclusions The hematogenous dissemination of colorectal cancer plays an important role in postoperative relapse. The dynamic monitoring of CK 20 predicts hematogenous dissemination of colorectal cancer.