胃肠道癌患者外周血癌胚抗原信使核糖核酸的检测及其临床意义

目的：应用RT—PCR法检测胃肠道癌患者外周静脉血CEAmRNA，探讨与不同临床病理指标之间的关系，评估对临床治疗和预后的指导意义。方法：应用RT—PCR技术，选择特异性CEAmRNA引物，检测41例胃癌、大肠癌患者外周血CEAmRNA，同时定量检测外周血CEA和CA19—9糖蛋白。另抽取12例健康志愿者外周血标本作为对照。结果：41例胃肠癌患者外周血中CEAmRNA、CEA、CA19—9阳性率分别为26．8％、19．5％、14．6％。12例对照外周血中CEAmRNA、CEA、CA19—9均阴性。有淋巴结转移者外周血CEAmRNA阳性率（40％，10／25）高于无淋巴结转移者（6．25％，1／16），P=0．000。TNM分期Ⅳ期中外周血CEAmRNA阳性率63．6％（7／11），Ⅲ期21．4％（3／14），Ⅰ、Ⅱ期6．3％（1／16），P=0．004。外周血CEAmRNA表达在不同年龄、性别、病理类型中无统计学差异（P〉0．05）。结论：CEAmRNA、CEA和CA19—9在胃肠道癌患者中的阳性率，以CEAmRNA阳性率最高，随淋巴结转移数目、病期进展，阳性率更高，可能预后不良。

Clinical significance of peripheral blood CEAmRNA in patients with gastrointestinal tract cancers

Objective：To detect the expression of carcinoembryonic antigen （CEA） mRNA in peripheral blood samples of patients with gastrointestinal tract cancers by RT - PCR and to explore the relationship among CEAmRNA expression and different clinical pathological indexes and to evaluate the significance of CEAmRNA expression in clinical treatment and prognosis. Methods ： The CEAmRNA were detected by RT - PCR using CEA - specific primers in peripheral blood of 41 patients with gastrointestinal tract cancers. The CEA and carbohydrate antigen 19 -9 （CA19 - 9） glycoproteins were detected in the peripheral blood of those patients at the same time,12 healthy volunteers were selected as control. Results： The positive rates of CEAmRNA, CEA, CA19 - 9 were 26. 8%, 19.5%, 14.6% of 41 patients, respectively. CEAmRNA, CEA, CA19 -9 in controls were all negative. The positive rate of CEAmRNA of patients with lymph nodes metastasis （40%, 10/25 ）was higher than that of patients without lymph nodes metastasis （6.25% ,1/16） （P = 0.000）. The positive rates of CEAmRNA in Ⅲ, Ⅳ, Ⅰ and Ⅱ stages were 63.6% （7/11）, 21.4% （3/14）, 6.3% （1/16）, respectively, and the difference was significant（P = 0.004）. However, the CEAmRNA expression didnt show significant difference in age, sex and pathological types （P 〉 0.05 ）. Conclusion： The positive rate of CEAmRNA is the highest among CEAmRNA, CEA and CA 19 - 9 in patients with gastrointestinal tract cancers. The more of the metastatic lymph nodes numbers and the higher clinical stages of thecancers, the higher of the positive rate of CEAmRNA is. The positive expression of CEAmRNA seems to be the marker of poor prognosis.