结直肠癌外周血和腹膜腔微转移影响因素分析

目的 探讨结直肠癌患者外周血和腹膜腔微转移及其影响因素.方法 收集施行手术治疗的90例结直肠癌患者和25例结直肠良性疾病患者外周血及腹腔灌洗液,RT-PCR方法检测CK-20mRNA和CEAmRNA表达;手术切除标本常规病理学分析.结果 (1)结直肠癌患者外周血CK-20mRNA和CEAmRNA表达率分别为45.6%(41/90)和54.4%(49/90),两者联合检测表达的阳性率为64.4%(58/90);腹膜腔CK-20mRNA和CEAmRNA表达阳性率分别为51.1%(46/90)和58.9%(53/90),两者联合检测表达的阳性率为68.9%(62/90);上述指标均随肿瘤的浸润深度、PS因素的递进,以及淋巴结及肝脏转移而增高(P<0.05);在结直肠良性疾病患者外周血及腹腔灌洗液标本中均未检出CK-20mRNA和CEAmRNA的表达.(2)腹腔灌洗液中CK-20mRNA和(或)CEAmRNA表达的阳性率与同一指标在外周血中的表达相比无差异;外周血及腹腔灌洗液中CEAmRNA的表达与CK-20mRNA表达相比也无差异.结论 采用RT-PCR方法检测结直肠癌患者外周血和腹膜腔CK-20mRNA和CEAmRNA的表达,有助于筛选亚临床转移和预测病理分期;两者的联合检测更有意义.

Influencing factors of micrometastasis in peripheral blood and peritoneal cavity of colorectal cancer

Objective To investigate the influencing factors of micrometastasis in peripheral blood and peritoneal cavity of colorectal cancer. Methods Peripheral blood samples and irrigation of peritoneal cavity were collected from 90 cases of colorectal cancer and 25 cases of colorectal benign disease. RT-PCR was used to detect the expression of CK-20mRNA and CEAmRNA and the surgical specimens were taken for pathological analysis. Results The positive rates of CK-20mRNA,CEAmRNA and dual positive rates of CK-20mRNA and CEAmRNA in peripheral blood of patients with colorectal cancer were 45.6%(41/90),54.4%(49/90) and 64.4%(58/90),respectively;the positive rates of the same indicators in peritoneal cavity were 51.1%(46/90),58.9%(53/90) and 68.9%(62/90),respectively. All above parameters were significantly increased with the infiltration of tumors,PS factors,metastasis to lymph node or liver. CK-20mRNA and CEAmRNA were negative in peripheral blood and peritoneal cavity of all patients with benign colorectal diseases. There were no significant differences in positive rates of CK-20mRNA and/or CEAmRNA between peritoneal cavity and peripheral blood; there were no significant differences between positive rate of CEAmRNA and that of CK-20mRNA expressed in both peripheral blood or peritoneal cavity. Conclusion The detection of CK-20mRNA and/or CEAmRNA in peripheral blood and peritoneal cavity contributes to identification of subclinical metastasis and clinicopathological staging of colorectal cancer.