CAJ | 학술논문

目的探讨实时荧光定量逆转录聚合酶链反应(fqRT-PCR)技术评价食管癌患者外周血中循环肿瘤细胞(CTCs)的临床价值.方法以43例病理确诊的食管鳞癌及10例胸部良性疾病患者为研究对象,将癌胚抗原(CEA)作为检测标志物,应用fqRT-PCR方法定量检测其外周血CEA mRNA表达及拷贝数,评价食管鳞癌患者CTCs状况.结果食管鳞癌患者外周血CEA mRNA阳性表达率为46.51%(20/43),胸部良性病变患者外周血未见阳性表达;其阳性率随肿瘤TNM分期增高;Ⅲ、Ⅳ期患者CEA mRNA阳性率显著高于Ⅰ、Ⅱ期(P＜0.05),但Ⅰ、Ⅱ期患者之间及Ⅲ、Ⅳ期患者之间差异无统计学意义(P＞0.05);外周血CEA mRNA拷贝数在Ⅳ期患者明显高于Ⅰ、Ⅱ、Ⅲ期患者(P＜0.01);但在Ⅰ、Ⅱ、Ⅲ期患者间其拷贝数差异无统计学意义(P＞0.05).CEA mRNA表达与癌细胞分化程度无明显相关.随访结果:外周血CEA mRNA阳性表达者其转移预测特异性为81.25%(13/16).结论 fqRT-PCR检测食管癌患者外周血CEA mRNA有较高的敏感性和特异性,是监测食管癌CTCs较为可靠的一种方法.
목적 탐토실시형광정량역전록취합매련반응(fqRT-PCR)기술평개식관암환자외주혈중순배종류세포(CTCs)적림상개치.방법 이43례병리학진적식관린암급10례흉부량성질병환자위연구대상,장암배항원(CEA)작위검측표지물,응용fqRT-PCR방법정량검측기외주혈CEA mRNA표체급고패수,평개식관린암환자CTCs상황.결과 식관린암환자외주혈CEA mRNA양성표체솔위46.51%(20/43),흉부량성병변환자외주혈미견양성표체;기양성솔수종류TNM분기증고;Ⅲ、Ⅳ기환자CEA mRNA양성솔현저고우Ⅰ、Ⅱ기(P＜0.05),단Ⅰ、Ⅱ기환자지간급Ⅲ、Ⅳ기환자지간차이무통계학의의(P＞0.05);외주혈CEA mRNA고패수재Ⅳ기환자명현고우Ⅰ、Ⅱ、Ⅲ기환자(P＜0.01);단재Ⅰ、Ⅱ、Ⅲ기환자간기고패수차이무통계학의의(P＞0.05).CEA mRNA표체여암세포분화정도무명현상관.수방결과:외주혈CEA mRNA양성표체자기전이예측특이성위81.25%(13/16).결론 fqRT-PCR검측식관암환자외주혈CEA mRNA유교고적민감성화특이성,시감측식관암CTCs교위가고적일충방법.
Objective To evaluate circulating tumor cells (CTCs) in peripheral blood of patients with primary esophageal squamous cancer by real-time fluorescent quantitative reverse transcription-polymerase chain reaction (fqRT-PCR). Methods Carcinoembryonic antigen (CEA) mRNA was detected in the peripheral blood samples of 43 patients with primary esophageal squamous cancer and 10 controls by real-time fqRT-PCR. Results Twenty of 43 (46.51%) patients with esophageal squamous cancer had detectable CEA mRNA in peripheral blood samples and there was no detectable CEA mRNA in control group.The positive expression rate of CEA mRNA was significantly higher in patients with TNM stage Ⅲ, Ⅳ than that in stage Ⅰ , Ⅱ (P＜0.05), but there was no significant difference between stage Ⅰ and Ⅱ , neither between stage Ⅲ and Ⅳ (P＞0.05). CEA mRNA copies were significantly higher in patients with stage Ⅳ than that in stage Ⅰ , Ⅱ , Ⅲ (P＜0.01), but there were no significant differences among stage Ⅰ , Ⅱ and Ⅲ (P＞0.05). There was no correlation between the expression of CEA mRNA and cancer cell differentiation. The follow-up data showed the specificity for predicting metastasis of high CEA mRNA level in peripheral blood was 81.25% (13/16). Conclusion The detection of CEA mRNA in peripheral blood by fqRT-PCR is a sensitive, specific and reliable method to monitor the CTCs in patients with esophageal squamous cancer.