大肠癌病人血循环中CEAmRNA的表达及临床意义

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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DukesA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(5 5 6 % )vs3/ 2 6 (11 5 % ) ,P =0 0 2 4 ]。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。 Objective To observe the relationship between the presence of tumor cells in blood circulation and the staging of colorectal cancer and the occurrence of postoperative liver metastasis in patients with colorectal cancer. Methods CEA mRNA was used as a marker of tumor cells to detect the preoperative peripheral blood, portal vein blood and micro-metastatic tumor cells in peripheral blood of 38 patients with colorectal cancer by RT-PCR. Results The positive detection rate of CEA mRNA in blood circulation was closely related to the Dukes stage of colorectal cancer. There was positive expression of CEA mRNA in preoperative peripheral blood and intraoperative portal vein even in Dukes A stage patients (33.3%). Follow-up found that patients with colorectal cancer with positive CEAmRNA in blood circulation, especially postoperative peripheral blood, were significantly more likely to have liver metastases in the future than those with negative CEAmRNA [5 of 9 (55.6% vs 3/26 (11.5% ), P = 0 0 2 4]. Conclusion Detection of tumor cells in the blood circulation of patients with colorectal cancer has important clinical significance for the accurate assessment of the prognosis of colorectal cancer.
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