CAJ | 학술논문

目的探讨外周血鸟苷酸环化酶(GC-C) mRNA和细胞角蛋白20 (CK20) mRNA水平与早中期结直肠癌患者肿瘤转移及预后的关系.方法应用荧光定量聚合酶链反应技术,检测74例早中期结直肠癌患者术前外周血GC-C mRNA以及CK20 mRNA的表达,并结合临床和病理各项指标以及术后随访资料,对患者肿瘤转移危险因素和预后进行统计学分析和评价.结果 74例结直肠癌患者外周血GC-C mRNA阳性率为33.8％(25/74),CK20 mRNA阳性率为31.1％(23/74)；1、2、3年无瘤生存率分别为94.6％、82.4％和78.4％.单因素预后分析发现,外周血GC-C mRNA、CK20 mRNA、肿瘤分化类型、有无肠系膜根部淋巴结转移、有无脉管瘤栓和术后是否接受化疗6因素与本组患者3年无瘤生存有关(均P＜0.05)；有无肠系膜根部淋巴结转移和有无脉管瘤栓是预后的独立影响因素(P＜0.05).按肿瘤分期分层分析,外周血CK20 mRNA和有无脉管瘤栓是Ⅲ期结直肠癌患者3年无瘤生存率的独立影响因素(P＜0.05).结论检测外周血CK20 mRNA、GC-C mRNA对于早期发现早中期结直肠癌转移可能具有重要的临床意义.
목적 탐토외주혈조감산배화매(GC-C) mRNA화세포각단백20 (CK20) mRNA수평여조중기결직장암환자종류전이급예후적관계.방법 응용형광정량취합매련반응기술,검측74례조중기결직장암환자술전외주혈GC-C mRNA이급CK20 mRNA적표체,병결합림상화병리각항지표이급술후수방자료,대환자종류전이위험인소화예후진행통계학분석화평개.결과 74례결직장암환자외주혈GC-C mRNA양성솔위33.8％(25/74),CK20 mRNA양성솔위31.1％(23/74)；1、2、3년무류생존솔분별위94.6％、82.4％화78.4％.단인소예후분석발현,외주혈GC-C mRNA、CK20 mRNA、종류분화류형、유무장계막근부림파결전이、유무맥관류전화술후시부접수화료6인소여본조환자3년무류생존유관(균P＜0.05)；유무장계막근부림파결전이화유무맥관류전시예후적독립영향인소(P＜0.05).안종류분기분층분석,외주혈CK20 mRNA화유무맥관류전시Ⅲ기결직장암환자3년무류생존솔적독립영향인소(P＜0.05).결론 검측외주혈CK20 mRNA、GC-C mRNA대우조기발현조중기결직장암전이가능구유중요적림상의의.
Objective To investigate the associations of guanylate cyclase C(GC-C) mRNA and cytokeratin 20 (CK20) mRNA with metastasis and prognosis in early to moderate colorectal cancer patients.Methods GC-C mRNA and CK 20 mRNA in peripheral blood of 74 colorectal cancer patients without distant metastasis were detected by fluorescent quantitative PCR (FQ-PCR).Based on their clinicopathological and postoperative follow-up data,the relationship and clinical significance of these data with metastasis hazards and prognosis factors were analyzed.Results The positive rate of GC-C mRNA in 74 colorectal cancer patients was 33.8％ (25/74),and CK20 mRNA was 31.1％ (23/74).The 1-,2-,3-year disease-free survival rates of patients were 94.6％、82.4％ and 78.4％ respectively.There were significant differences in positive rates of GC-C mRNA and CK20 mRNA,tumor differentiation,mesentery lymph node metastasis,tumor embolus in vessel and postoperative chemotherapy associated with 3-year disease free survival rate by Kaplan-Meier analysis (all P＜0.05).While mesentery lymph node metastasis and tumor embolus in vessel were independent risk factors of 3-year disease-free survival (P＜0.05).CK20 mRNA and tumor embolus in vessel were independent risk factors of 3-year disease-free survival by analysis stratified with clinical stage (P＜0.05).Conclusions Detection of CK20 mRNA and GC-C mRNA in peripheral blood may be important for early detection of early metastasis of colorectal cancer.