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目的 观察大肠癌病人血循环中肿瘤细胞的存在与大肠癌的分期以及术后发生肝转移之间的关系。方法 以CEAmRNA为肿瘤细胞的标志物，利用RT-PCR检测了38例大肠癌病人的术前外周血、术中门静脉血和术后外周血中微转移的肿瘤细胞。结果 血循环中CEAmRNA的阳性检出率与大肠癌的Dukes分期密切相关，即使在Dukes A期的病人中也有术前外周血和术中门静脉血中CEAmRNA的表达阳性者（33.3%）。随访发现，血循环中尤其术后外周血中CEAmRNA呈阳性的大肠癌病人日后发生肝转移的机率大大高于CEAmRNA呈阴性的病人5/9（55.6%)vs3/26(11.5%),P=0.024]。结论 检测大肠癌病人血循环中的肿瘤细胞对于准确评估大肠癌预后具有较为重要的临床意义。

Expression of CEAmRNA in blood circulation and its clinical significance in patients with colorectal cancer

Objective\ To observe the relationship between the presence of blood circulation micrometastases in patients with colorectal cancer and Dukes stage,postoperative liver metastasis.Methods\ Using CEAmRNA as tumor cell mark,the micrometastases in peripheral venous blood before and after operation,and portal vein blood during operation were detected in 38 cases by means of RT-PCR.Results\ CEAmRNA positivity significantly correlated with Dukes stage.Even in Dukes A stage,there were 33 3% patients with CEAmRNA positive in portal venous and preoperative peripheral blood.CEAmRNA positivity in postoperative peripheral blood significantly correlated with the rate of postoperative hepatic metastasis(positive:55 6% vs negative:11 5%),WTBX]P=0 024]..Conclusion\ Detection of blood circulation micrometastases in patients with colorectal cancer has important clinical significance in more accurately evaluating the prognosis.