CAJ | 학술논문

目的检测结直肠癌术中腹腔灌洗液悬浮细胞中CDH1基因甲基化状态并探讨其与结直肠癌临床病理资料及预后的关系.方法前瞻性纳入2011年10月至2013年10月间中山市中医院手术治疗的原发性结直肠癌患者.采用实时荧光甲基化特异性聚合酶链反应技术,检测术中腹腔灌洗液悬浮细胞中CDH1基因启动子区域5'-CpG岛的甲基化状态,将甲基化百分率大于20％定义为甲基化,小于或等于20％为非甲基化;分析CDH1基因甲基化状态与结直肠癌临床病理特征及预后的关系.结果共102例患者纳入研究,其中CDH1甲基化组47例,非甲基化组55例.与非甲基化组比较,甲基化组患者肿瘤直径更大,浸润型比例更高,分化程度更低,淋巴结转移和远处转移率更高,临床分期更晚(均P＜0.05).甲基化组患者中位生存期短于非甲基化组(26.0月比41.4月,P＜0.05).Cox模型分析显示,CDH1甲基化状态是结直肠癌患者术后生存的独立危险因素(RR=27.5,95％CI:3.8～51.3,P＜0.01].结论术中腹腔灌洗液悬浮细胞中CDH1基因发生甲基化的结直肠癌患者恶性程度较高,易发生淋巴结转移和远处转移,预后较差.
목적 검측결직장암술중복강관세액현부세포중CDH1기인갑기화상태병탐토기여결직장암림상병리자료급예후적관계.방법 전첨성납입2011년10월지2013년10월간중산시중의원수술치료적원발성결직장암환자.채용실시형광갑기화특이성취합매련반응기술,검측술중복강관세액현부세포중CDH1기인계동자구역5'-CpG도적갑기화상태,장갑기화백분솔대우20％정의위갑기화,소우혹등우20％위비갑기화;분석CDH1기인갑기화상태여결직장암림상병리특정급예후적관계.결과 공102례환자납입연구,기중CDH1갑기화조47례,비갑기화조55례.여비갑기화조비교,갑기화조환자종류직경경대,침윤형비례경고,분화정도경저,림파결전이화원처전이솔경고,림상분기경만(균P＜0.05).갑기화조환자중위생존기단우비갑기화조(26.0월비41.4월,P＜0.05).Cox모형분석현시,CDH1갑기화상태시결직장암환자술후생존적독립위험인소(RR=27.5,95％CI:3.8～51.3,P＜0.01].결론 술중복강관세액현부세포중CDH1기인발생갑기화적결직장암환자악성정도교고,역발생림파결전이화원처전이,예후교차.
Objective To detect the CDH1 gene methylation of suspension cells in intraoperative abdominal lavage fluid from colorectal cancer patients,and to examine its association with clinicopathology and prognosis.Methods Real-time methylation-specific polymerase chain reaction (qMSP) was used to investigate the methylation status of the CDH 1 gene promoter 5'-CpG islands from intraoperative abdominal lavage fluid in 102 patients with colorectal cancer.The associations between methylation of CDH1 genes and clinicopathologic features and prognosis were investigated.Results Among the 102 colorectal cancer patients,aberrant methylation of CDH1 gene was detected in 47 patients.Significant associations were found between CDH1 methylation status and tumor size,growth pattern,differentiation,distant metastasis,and clinical staging (all P＜0.05).The median progression-free survival was 25.98 months for CDH1 methylation group and 41.36 months for non-methylated group,and the difference was statistically significant(P＜0.01).Cox model analysis revealed that CDH1 methylation status in intraoperative peritoneal lavage fluid was an independent factor associated with postoperative survival in colorectal cancer patients (50.23％ vs.86.51％,P=0.001).Conclusions Colorectal cancer patients with aberrant methylation of 5'-CpG of CDH1 gene promoter of suspension cells in abdominal lavage have higher malignancy,more metastasis and worse prognosis.