胃癌患者外周血及骨髓微转移检测的临床意义

目的:探讨检测胃癌患者外周血和骨髓CK20 mRNA表达的敏感性、特异性及临床意义.方法:采用RTPCR技术,同时对照检测49例胃癌患者、5例胃良性病变患者及5例健康志愿者骨髓与外周血中的CK20 mRNA表达.结果:49例胃癌患者中,骨髓和外周血CK20阳性表达率分别为49.0%(24/49),32.7%(16/49),二者差异有统计学意义(P＜0.05).其中2例外周血CK20表达阳性,骨髓表达阴性.健康志愿者及良性病变患者外周血及骨髓中未检测到CK20表达.本实验中CK20 mRNA RT-PCR技术的灵敏度为10～-5.胃癌的微转移状况与组织分化程度和肿瘤TNM分期有关.结论:应用RT-PCR法以CK20为标志物检测胃癌微转移细胞特异性高.骨髓检测胃癌微转移较单次采血更敏感,但外周血检测仍能提供一些有价值的资料.

Significance of Detecting Micrometasteses in Peripheral Blood and Bone Marrow of Patients with Gastric Cancer

Objective: To evaluate the specificity, sensitivity and their clinical significance of CK20 mRNA expression in the peripheral blood and bone marrow of patients with gastric cancer. Methods: Expression of CK20 mRNA was investigated by RT-PCR in peripheral blood and bone marrow in 49 patients with gastric cancer, 5 patients with benign gastric lesion and 5 healthy volunteers. Results: The positive rate of CK20 mRNA were 49.0%(24/49) in bone marrow and 32.7%(16/49) in peripheral blood, with a significant difference between the two groups(P<0.05). There were 2 cases with negative results in bone marrow and positive results in peripheral blood. No CK20 mRNA expression was found in the samples of patients with benign gastric lesion and healthy volunteers. The sensitivity of CK20 mRNA RT-PCR was 10-5 in our study. The micrometastasis in peripheral blood and bone marrow was closely correlated with the histological differentiation and TNM staging. Conclusion: Using CK20 mRNA as a marker, the detection of micrometastasis with RT-PCR technique shows favorable specificity. Bone marrow is more sensitive to detect micrometastasis than peripheral blood (one test), but the latter can still provide some valuable data.