胰腺癌外周血中CK20mRNA的表达及临床意义

目的应用荧光定量逆转录聚合酶联反应（RT-PCR）检测胰腺癌外周血中cK20mRNA的表达及其临床意义。方法用荧光定量RT-PCR检测40例作根治术的胰腺癌病人外周血中CK20mRNA，并与病人的临床病理学指标、随访结果进行相关性研究。结果40例胰腺癌外周血中CK20mRNA阳性率57．5％（23／40），CK20mRNA的表达与年龄、性别、肿瘤大小无关，与肿瘤分化程度、淋巴结转移、临床分期有相关性。随访发现CK20mRNA阳性病人术后6个月（P=0．043）或1年内（P=0．02）肿瘤转移的可能性明显大于阴性病人。外周血中CK20mRNA阳性病人预后不良，其生存率明显低于阴性病人（Log Rank=13．31，P=0．0003）。结论CK20mRNA是检测胰腺癌外周血中微转移的敏感指标，CK20mRNA的表达与肿瘤的生物学行为有关，并能预测胰腺癌预后和决定采用更有效的辅助治疗。

Expression of CK20 mRNA in peripheral blood of patients with pancreatic carcinoma and its clinical significance

Objective To detect the expression of CK20 mRNA in peripheral blood of patients with pancreatic carcinoma and explore its clinical significance.Methods Tile expression of CK20 mR- NA in the peripheral blood was determined with fluorogenic quantitative RT-PCR in 40 cases of pan- creatic carcinoma in the night before operation,5 cases of benign pancreatic diseases and 5 healthy in- dividuals.The relationship between CK20 mRNA expression and clinicopathological variables was in- vestigated.Meanwhile,the patients with pancreatic carcinoma were followed up after radical resection of the tumor.Results Twenty-three(57.5%)of the 40 patients with pancreatic carcinoma were posi- tive for CK20 mRNA expression.The expression was significantly correlated to lymphatic metastasis (P=0.008),histopathological grading(P=0.009)and pathological stage(P=0.021).However,it was not significantly correlated with age,gender,tumor diameter and depth of invasior.The cumula- tive metastasis rate was markedly higher in the patients with CK20 mRNA expression than in those without within 6 months(34.7% vs.5.9%,P=0.043)or 12 months(73.9% vs.35.3%,P= 0.02)after operation.CK20 mRNA expression in the peripheral blood of the patients with pancreatic carcinoma indicated poorer prognosis.The survival rate was remarkably lower in the patients with CK20 mRNA expression than in those without(P=0.0003).Conclusions CK2.0 mRNA is a sensitive and specific molecular marker for detection of micrometastasis in the peripheral blood of the patients with pancreatic carcinoma.The expression is correlated to biological characteristics of the pancreatic carcinoma.The detection of the expression can help to predict the prognosis of the tumor after opera- tion and determine which patient will benefit from aggressive adjuvant therapies.