大肠癌患者外周血微转移的诊断研究

目的:检测大肠癌患者外周血中CK20mRNA和hTERT mRNA的表达,探讨其能否作为诊断外周血微转移的生物学指标。方法:采用RT-PCR法检测60例大肠癌患者、21例肠道良性病变患者和20例健康体检者外周血中两项指标的表达。结果:1CK20mRNA和hTERT mRNA在大肠癌患者外周血中的阳性表达率分别为51.67%和56.67%,相对系数分别为0.88±0.14和0.89±0.17;肠道良性病变患者中阳性表达率分别为4.76%和0%,相对系数分别为0.11和0;健康体检者阳性表达率及相对系数均为0。大肠癌患者与肠道良性病变患者、健康体检者相比,二者的表达均有统计学差异。2RT-PCR法检测大肠癌患者外周血中两项指标诊断微转移的灵敏度为77.78%～88.89%,特异度为59.38%～93.75%。3两指标阳性者根治术后复发转移率高于阴性者,生存率低于阴性者。4两指标与CEA、CA19-9的表达呈正相关;hTERTmRNA阳性率高于CA199。结论:大肠癌患者外周血中存在CK20mRNA和hTERT mRNA的表达,可作为诊断大肠癌患者外周血微转移的分子生物学指标。

Diagnosing study on micrometastasis in peripheral blood of colorectal carcinoma patients

Objective：To detect the expression of CK20 mRNA and hTERT mRNA in peripheral blood of patients with colorectal carcinoma.To discuss whether they can be used as molecular biological markers of predicting micrometastasis in peripheral blood.Methods：Peripheral blood of 60 colorectal carcinoma patients,21 benign colorectal lesion patients,20 healthy examination cases were detected by RT-PCR technique.Results：① The positive rate of CK20 mRNA and hTERT mRNA in peripheral blood of patients with colorectal carcinoma was 51.67% and 56.67%,relative coefficient was 0.88±0.14 and 0.89±0.17;4.76% and 0% in benign colorectal lesion,relative coefficient was 0.11 and 0,respectively.CK20 mRNA and hTERT mRNA were not detected in peripheral blood of healthy people.Compared the expressions of the two markers in colorectal carcinoma patients with benign colorectal lesion patients and healthy people,there were all significant differences.②The expression of two markers which were detected by RT-PCR technique diagnose micrometastasis in peripheral blood of colorectal carcinoma patients with sensitivity of 77.78%～88.89%,specificity of 59.38%～93.75%.③The colorectal carcinoma patients who had radical resection with positive expression have higher recurrence or metastasis rates,and lower survival rates compared with negative expression patients.④ The expression of two markers were positively correlated with the expression of CEA and CA199 level.The positive expression rates of hTERT mRNA were higher than that of CA199.Conclution：CK20 mRNA and hTERT mRNA were positive expressed in peripheral blood of patients with colorectal carcinoma.The two markers can be used as molecular biological markers for predicting micrometastasis in peripheral blood and evaluating prognosis.