实时荧光定量RT-PCR检测胸、腹腔积液和癌胚抗原mRNA表达的临床意义

目的　探讨良、恶性胸腔腹腔积液中癌胚抗原 (CEA)mRNA表达的临床意义。　方法收集明确病理学诊断的恶性肿瘤 (5 8例 )及良性疾病患者 (76例 )的胸腔、腹腔积液 ,采用实时荧光定量RT PCR法检测其CEAmRNA的表达水平 ,并与脱落细胞学检查结果比较。　结果　 5 8例肿瘤患者胸、腹腔积液中 ,脱落细胞学检查有 19例 (32 8% )找到癌细胞 ,而CEAmRNA阳性 (>1CN)者为 4 6例 (79 3% ) ,二者阳性率差异具有极显著性意义 (χ2 =2 1 82 ,P =0 0 0 0 )。 76例良性疾病患者的胸、腹腔积液中CEAmRNA阳性 (>1CN)者为 19例 (2 5 0 % ) ,良性疾病与恶性肿瘤患者胸腔腹腔积液中CEAmRNA的表达水平差异有极显著性意义 (χ2 =38 85 ,P =0 0 0 0 )。　结论　采用实时荧光定量RT PCR法可定量检测胸、腹腔积液中CEAmRNA表达 ,其敏感性优于脱落细胞学检查 ,且有助于胸、腹腔积液良、恶性的鉴别。

Clinical significance of CEA mRNA detection in pleural and peritoneal effusions by real-time fluorescent quantitative RT-PCR

OBJECTIVES: To detect CEA mRNA levels in benign and malignant pleural and peritoneal effusions and evaluate their clinical significance. METHODS: Samples of pleural and peritoneal effusions from 58 patients with malignant diseases and 76 patients with benign diseases were collected and total RNAs were prepared and subjected to real-time fluorescent quantitative RT-PCR to determine the CEA mRNA levels in these samples. The positive rate of this examination was compared with that of shed cell pathological examination. RESULTS: Nineteen samples (32.8%) of pleural and peritoneal effusions from the 58 patients with malignant diseases showed positive results in shed cell examination, while the number of CEA mRNA >1 CN was 46 (79.3%) (chi(2) = 21.81, P = 0.000). Nineteen samples of pleural and peritoneal effusions from the 76 patients with benign diseases showed CEA mRNA > 1 CN (25.0%), which was significantly different from that of the patients with malignant diseases (chi(2) = 38.85, P = 0.000). CONCLUSION: CEA mRNA levels in pleural and peritoneal effusions can be quantified by real-time fluorescent quantitative PCR, which is more sensitive than shed cell pathological examination. This technique is helpful in discrimination of benign and malignant pleural and peritoneal effusions.