实时荧光定量RT-PCR检测直肠癌术后引流液细胞角蛋白19mRNA的临床意义

目的探讨实时定量PCR技术检测直肠癌术后引流液中细胞角蛋白19（CK-19）mRNA表达的临床意义。方法采用实时定量RT-PCR的技术，检测59例直肠癌根治手术后和15例腹部良性病变术后腹腔引流液中CK-19mRNA的表达。分析直肠癌根治术后腹腔引流液中CK-19mRNA的表达及其与肿瘤侵及深度、腹腔淋巴结转移、肿瘤分化程度的关系。结果直肠癌患者术后腹腔引流液CK一19mRNA表达的阳性率为67．8％（40／59，CK．19mRNA〉4为阳性标准），明显高于腹部良性病变患者。CKl9mRNA表达情况与浸润深度、淋巴结转移多少、组织学分化程度有关，组间差异具有统计学意义（X^2值分别为8．47、9．19、8．32，P〈0．05或P〈0．01）；结论而且CK19mRNA表达与病理级别具有相关性，淋巴结转移分级越高，直肠癌术后引流液中CK-19mRNA越高（r=0．674，P：0．021）；分化程度越低，术后引流液中CK-19mRNA表达越高（r=-0．741，P=0．014）。结论RT-PCR检测术后腹腔引流液中CK-19mRNA浓度提高直肠癌微转移诊断的敏感性；RT-PCR有助于判断直肠癌术后微转移，是指导术后治疗并评估预后的好方法。

The clinical significance of CK-19 mRNA expression in the axillary drainage fluid of rectal cancer patients with real-time RT-PCR detection

Objective To detect CK-19 mRNA expression by quantitative real-time RT-PCR in axillary drainage fluid of rectal cancer and investigate its clinical significance. Methods Axillary drainage fluids were collected from 59 patients with rectal cancer and 15 patients with benign abdominal lesion from Sep. 2010 to Dec. 2010. Level of CK-19 mRNA in axillary drainage fluid was detected using specific primers by real-time RT- PCR. The data were statistically analyzed to investigate the relationships between CK-19 mRNA level and tumor invasion,lymph node status, tumor stage and tumor differentiation level. Results The positive rate of CK-19 mRNA expression in patients with rectal cancer was 67.8% ,which was significantly higher than that in patients with benign abdominal lesion. The expression of CK-19 mRNA was significantly correlated with the depth of tumor invasion, lymphnode status, tumor stage and histopathologieal differentiation （ P 〈 O. 05 or P 〈 0. O1 ）. Ckl 9 mRNA expression was associated with the pathological level, the higher of the lymph node translation level, the higher expression in the axillary drainage fluid after rectal cancer surgery （r =0. 674,P =0. 021 ）. The lower of the lymph node differentiation level, the higher expression in the axillary drainage fluid after rectal cancer surgery （ r = - 0. 741, P = 0. 014）. Conclnsion Quantitative detection of CK-19 mRNA in axillary drainage fluid of rectal cancer by RT-PCR could enhance the diagnostic sensibility of colorectal cancer micrometastases. RT-PCR assay is suitable for predicting peritoneal micrometastasis of rectal cancer,which is a reference for postoperative treatment and prognosis prediction.