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目的探讨检测大肠癌患者术中腹腔冲洗液CEA、GCC和CD44v6 mRNA表达的临床意义。方法收集60例大肠肿瘤患者的术中腹腔冲洗液,其中大肠癌48例(大肠癌组),大肠良性病变12例(阴性对照组),以上标本均经病理学证实,并以人大肠癌细胞株SW480作为阳性对照;应用基于b-DNA信号放大的基因表达定量检测技术测定腹腔冲洗液中脱落细胞的CEA、GCC和CD44v6 mRNA表达,同时做腹腔冲洗液细胞学检查(PLC),进而结合临床相关资料分析CEA、GCC和CD44v6 mRNA表达的临床意义。结果大肠癌组腹腔冲洗液CEA、GCC、CD44v6的表达阳性率分别为43.8%(21/48)、60.4%(29/48)、31.2%(15/48),总阳性率为72.9%(35/48),高于腹腔冲洗液PLC的阳性率4.2%(2/48),上述3项指标在人大肠癌细胞株SW480中表达均为阳性;在阴性对照组中有1例CEA mRNA检出阳性,其余均为阴性表达。不同Dukes分期、肿瘤分化程度、浆膜侵犯程度、是否淋巴结转移对CEA、GCC和CD44v6 mRNA的阳性率差异有统计学意义(P<0.05),不同肿瘤大小、患者年龄和性别差异无统计学意义(P>0.05)。结论检测腹腔冲洗液中CEA、GCC和CD44v6 mRNA的表达有助于大肠癌腹腔微转移的预测及术后治疗方案的制定;GCC、CD44v6可作为检测大肠癌腹腔脱落癌细胞的指标;基于b-DNA信号放大的基因表达定量检测技术是一种预测腹腔微转移的有效方法。
Objective To investigate the clinical significance of detecting the expressions of CEA, GCC and CD44v6 mRNA in peritoneal washings of patients with colorectal cancer. Methods Intraperitoneal irrigation fluid was collected from 60 patients with colorectal cancer, including 48 cases of colorectal cancer (colorectal cancer group) and 12 cases of benign colorectal lesions (negative control group). The above specimens were confirmed by pathology and were expressed in human colorectal cancer cells Strain SW480 was used as a positive control. The expression of CEA, GCC and CD44v6 mRNA in exfoliated cells in peritoneal washings was detected by quantitative gene expression detection method based on b-DNA signal amplification. At the same time, the peritoneal washings cytology (PLC) Relevant data analysis of CEA, GCC and CD44v6 mRNA expression of clinical significance. Results The positive rates of CEA, GCC and CD44v6 expression in colorectal cancer group were 43.8% (21/48), 60.4% (29/48) and 31.2% (15/48), respectively. The total positive rate was 72.9% / 48), which was higher than that of PLC in peritoneal washings (4.2%, 2/48). The above three indexes were all positive in human colorectal cancer cell line SW480. In the negative control group, 1 case of CEA mRNA was detected Positive, the rest were negative. There were significant differences in the positive rates of CEA, GCC and CD44v6 mRNA between different stages of Dukes, degree of tumor differentiation, invasion of serosa and lymph node metastasis (P <0.05). There was no significant difference in tumor size, age and gender of patients (P> 0.05). Conclusion Detection of CEA, GCC and CD44v6 mRNA expression in peritoneal washings is helpful for the prediction of peritoneal micrometastases in colorectal cancer and the development of postoperative treatment regimens. GCC and CD44v6 can be used as indicators for detection of peritoneal carcinoma cells in abdominal cavity. Quantitative detection of DNA signal amplification gene expression is an effective method to predict micrometastasis in the abdominal cavity.