门静脉血CEA—mRNA、CK20-mRNA动态检测对早期诊断结直肠癌肝转移的意义

目的动态检测结直肠癌患者门静脉血CK20mRNA、CEAmRNA的表达情况，探讨其对早期诊断结直肠癌肝转移的临床意义。方法40例结直肠癌患者随机分为两组（各20例），实验组术中留置门静脉埋植式给药装置（implantable drug delivery system，IDDS），术后常规随访加用荧光定量RT—PCR方法动态检测门静脉血CK20mRNA、CEAmRNA的表达情况；对照组常规术后随访。结果两组病例术后发生肝转移的时间和比例无显著性差异，发生肝转移的病例中，在影像学检查检出病灶的同时，几乎均有外周血CEA的增高，3例未发生肝转移的病例也可见外周血CEA的增高，实验组发生肝转移的病例则在影像学检查检出病灶之前3-9月即有门静脉血CK20mRNA、CEAmRNA的表达阳性。结论门静脉血CEA—mRNA、CK20-mRNA动态检测比外周血CAE检测和影像学检查更敏感、特异性更高，是早期诊断结直肠癌肝转移的有效方法。

Clinical significance of dynamic CK20mRNA and CEAmRNA expression in portal-vein blood of early-diagnosis for liver metastasis from colorectal cancer

Objective To study the clinical significance of dynamic CK20mRNA and CEAmRNA expression in portal-vein blood of early-diagnosis for colorectal cancer. Methods 40 patients with colorectal cancer were randomized into 2 groups （20 each）. The patients in the study group were implanted a implantable drug delivery system （IDDS） in the portal vein. Expression of CK20mRNA and CEAmRNA were dynamically detected with fluorescence quantitative RT-PCR in portal-vein blood with common follow-up. The patients in the control group accepted common follow-up only. Results There were no significant difference in occurring time and rate of liver metastasis between two groups. CEA in peripheral blood were almost enhanced at the same time of imaging diagnosis. And the increaced CEA in peripheral blood were detected in some eases without liver metastasis. The positive expression of CK20mRNA and CEAmRNA in portal vein were detected 3-9 months before imaging diagnosis. Conclusions Dynamic detections of CK20mRNA and CEAmRNA expression in portal-vein blood are more sensitive and specific than CEA detection in peripheral blood and imaging check. It is a effective method of early-diagnosis for liver metastasis from colorectal cancer.