检测细胞角蛋白19和20对结直肠癌微转移的诊断意义

目的探讨检测细胞角蛋白19（CK19）和CK20的表达对结直肠癌微转移的诊断意义。方法采用RT-PCR方法检测44例结直肠癌患者（结直肠癌组）及18例非恶性病变腹部手术患者（良性病变组）门静脉血和外周血CK19和CK20的表达。结果良性病变组患者门静脉血和外周血均无CK19或CK20阳性表达。结直肠癌组患者外周血和门静脉血中CK19和（或）CK20均阳性表达者34例（77．3％）。与良性病变组比较，差异有统计学意义（P〈0．05）。结直肠癌组外周血CK19和CK20的阳性表达率分别为36．4％和52．3％．门静脉血则分别为59．1％和72．7％，高于外周血的阳性表达率（P〈0．05）：Ⅲ期结直肠癌患者CK19和（或）CK20的阳性表达率明显高于Ⅰ、Ⅱ期患者（P〈0．05）。外周血CK19和（或）CK20阳性表达者术后转移或复发率61．5％，明显高于仅在门静脉血中CK19和（或）CK20阳性者的25．0％（P〈0．05）。结论外周血和门静脉血中CK19和CK20的RT—PCR检测是判断结直肠癌患者有无血行微转移的敏感和特异性诊断方法之一。

Diagnostic significance of cytokeratin 19 and 20 expression on micrometastasis of colorectal cancer

Objective To inquire into the diagnostic significance of cytokeratin 19(CK19) and cytokeratin 20(CK20)expression on hematogenous micrometastasis of colorectal cancer.Methods Forty-four patients with colorectal cancer were collected as colorectal cancer groups, and another 18 patients treated with abdominal surgical operations because of benign diseases were collected as benign disease group.Blood of all the patients was harvested from their portal and peripheral veins,and CK 19 and CK20 levels in the blood were determined by RT-PCR.Results There were no positive expression of CK19 and CK20 in the portal and peripheral blood of all the patients in benign disease group.Of the colorectal cancer group,34 patients(77.3%)appeared positive expressions of CK19 and/or CK20 in portal and peripheral blood,and there was significant difference in the expressions of CK19 and CK20 between the two groups(P<0.05).Within the colorectal cancer group,the positive expression rates of CK19 and CK20 in peripheral blood were 36.4%and 52.3%.and the rates in portal blood were 59.1%and 72.7%.The rates of portal blood were significantly higher than those of peripheral blood(P<0.05).The positive expression rate in patients at stage Ⅲ was significantly higher than that in patients at stage Ⅰ or Ⅱ(P<0.05).The postoperative metastasis and recurrence rate of colorectal cancer in patients with positive expression of CK19 and CK20 in peripheral blood was 61.5%,which was significantly higher than that(25.0%)in patients with positive expression in portal blood only(P<0.05).Conclusions In patients with eolorectal cancer,the expressions of CK19 and CK20,which are determined by RT-PCR in blood from portal and peripheral veins,are the sensitive and specific indexes for diagnosing hematogenous micrometastasis of the cancer.