CAJ | 학술논문

目的对直肠癌患者系膜切缘微转移灶进行检测,研究其对局部复发的影响.方法对52例Dukes A、B和C期直肠癌患者实施伞直肠系膜切除术,用RT-PCR技术检测系膜切缘组织细胞中角质蛋白CK20 mRNA.结果本组52例直肠癌旁系膜中,21例CK20 mRNA呈阳性,31例为阴性,总阳性率为40%.Dukes A、B和C期阳性率分别为17%、30%和54%,直肠系膜切缘微转移发生率随肿瘤分期升高而增加,组间比较差异有统计学意义,P<0.05;高、中、低与未分化癌阳性表达率分别为43%、38%、40%和50%,病理分级之间CK20 mRNA表达阳性率差异无统计学意义(P>0.05).全组患者局部复发率为12%,CK20 mRNA阳性组和阴性组局部复发率分别为24%和3%,两组比较差异有统计学意义,P<0.05.结论直肠系膜切缘微转移与局部复发有关,提示系膜CK20mRNA可能是一个潜在的局部复发标志物.
목적 대직장암환자계막절연미전이조진행검측,연구기대국부복발적영향.방법 대52례Dukes A、B화C기직장암환자실시산직장계막절제술,용RT-PCR기술검측계막절연조직세포중각질단백CK20 mRNA.결과 본조52례직장암방계막중,21례CK20 mRNA정양성,31례위음성,총양성솔위40%.Dukes A、B화C기양성솔분별위17%、30%화54%,직장계막절연미전이발생솔수종류분기승고이증가,조간비교차이유통계학의의,P<0.05;고、중、저여미분화암양성표체솔분별위43%、38%、40%화50%,병리분급지간CK20 mRNA표체양성솔차이무통계학의의(P>0.05).전조환자국부복발솔위12%,CK20 mRNA양성조화음성조국부복발솔분별위24%화3%,량조비교차이유통계학의의,P<0.05.결론 직장계막절연미전이여국부복발유관,제시계막CK20mRNA가능시일개잠재적국부복발표지물.
Objective To evaluate the impact of mesoreetal margin micrometastasis on local recurrence of rectal carcinoma after total mesorectal excision, and the relation between mesorectal margin mierometastasis and local recurrence. Methods Mesorectal margin specimens from 52 cases of rectal cancer after total mesorectal excision were studied by reverse transcriptase-polymerse chain reaction (RT-PCR) to detect the expression of CK20 mRNA. These patients were divided into CK20 mRNA positive and negative group and followed up for 3 years until local recurrence developed. Results In 52 patients with rectal cancer,21 cases were found to express CK20 mRNA in mesorectal margin, the expression rate of CK20 mRNA in Dukes A,B and C was 17% ,30% and 54% (P<0.05), respectively. The positive rate of well differentiated, moderately differentiated, poorly differentiated and undifferentiated carcinomas were 43%, 38% ,40% and 50% ,respectively(P>0.05 ). The incidence of local recurrence in CK20 mRNA positive and negative group was 24% and 3% , respectively. The difference was statistically significant between the two groups (P <0.05 ). Conclusion Detection of mesorectal margin CK20 mRNA as micrometastasis by RT-PCR in rectal carcinoma patients was a sensitive and effective way in predicting local recurrence. It is necessary for patients with positive mesorectal margin CK20 mRNA to undergo postoperative radiotherapy after total mesorectal excision.