中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2015年
4期
225-230
,共6页
刘少平%聂磊%胡亚华%张险峰%胡晓岚%方春华
劉少平%聶磊%鬍亞華%張險峰%鬍曉嵐%方春華
류소평%섭뢰%호아화%장험봉%호효람%방춘화
结直肠肿瘤%门静脉血%端粒,末端转移酶%RNA,信使%肝转移%预后
結直腸腫瘤%門靜脈血%耑粒,末耑轉移酶%RNA,信使%肝轉移%預後
결직장종류%문정맥혈%단립,말단전이매%RNA,신사%간전이%예후
Colorectal neoplasms%Portal vein%Telomerase%RNA,messenger%Liver metastasis%Prognosis
目的 探讨结直肠癌患者外周血和门静脉血的人端粒酶反转录酶(hTERT) mRNA的表达与其肝转移及预后的关系.方法 纳入2009年1月至2011年4月确诊并行根治性手术治疗的原发性结直肠癌患者181例.应用荧光定量PCR法检测所有患者术前外周血和术中门静脉血的hTERT mRNA相对表达量.所有患者术后随访3年.分别比较同时性肝转移(18例)和无同时性肝转移(163例)患者,以及异时性肝转移(29例)和无异时性肝转移(152例)患者的术前外周血和术中门静脉血hTERT mRNA的相对表达量;分析术中门静脉血hTERT mRNA相对表达量与结直肠癌患者临床病理特征的关系;均采用t检验.对结直肠癌患者异时性肝转移风险进行单因素和多因素分析.采用Log-rank法比较术中门静脉血hTERT mRNA高表达组与低表达组的术后生存率.结果 同时性肝转移患者术前外周血和术中门静脉血hTERT mRNA的相对表达量分别为8.04±3.79和11.88±4.19,无同时性肝转移患者术前外周血和术中门静脉血hTERT mRNA的相对表达量分别为4.30±2.81和4.94±3.37,前者均高于后者(t=5.159,8.084;P均＜0.01);异时性肝转移患者术前外周血和术中门静脉血hTERT mRNA相对表达量分别为7.16±3.08和9.83±2.96,无异时性肝转移患者术前外周血和术中门静脉血hTERT mRNA相对表达量分别为4.11±2.58和4.56±3.09,前者均高于后者(t=5.648,8.467;P均＜0.01).结直肠癌患者术中门静脉血hTERT mRNA的表达在不同肿瘤分化程度、不同肿瘤大小、不同肿瘤浸润深度、有否淋巴结转移、有否术后复发、不同术后生存期患者中差异均有统计学意义(t=2.987,2.281,2.135,5.070,5.431,6.803;P均＜0.05).单因素分析显示,术前外周血和术中门静脉血hTERT mRNA表达均与异时性肝转移相关(x2=9.522,16.393;P均＜0.01);Cox多因素回归分析显示,以上两者均是其独立危险因素(相对危险度分别为4.286,9.783).术中门静脉血hTERT mRNA高表达组患者的术后2和3年的生存率分别为64.6％和52.3％,低表达组分别为91.4％和85.3％;两组术后2和3年的生存率分别比较,差异均有统计学意义(x2=5.313,P＜0.05;x2 =8.925,P＜0.01).结论 术中门静脉血hTERT mRNA的表达与结直肠癌患者的重要病理特征及其肝转移、预后密切相关,其对异时性肝转移的预测价值比外周血hTERT mRNA高.术中门静脉血hTERT mRNA可成为结直肠癌患者术后预后的评价指标.
目的 探討結直腸癌患者外週血和門靜脈血的人耑粒酶反轉錄酶(hTERT) mRNA的錶達與其肝轉移及預後的關繫.方法 納入2009年1月至2011年4月確診併行根治性手術治療的原髮性結直腸癌患者181例.應用熒光定量PCR法檢測所有患者術前外週血和術中門靜脈血的hTERT mRNA相對錶達量.所有患者術後隨訪3年.分彆比較同時性肝轉移(18例)和無同時性肝轉移(163例)患者,以及異時性肝轉移(29例)和無異時性肝轉移(152例)患者的術前外週血和術中門靜脈血hTERT mRNA的相對錶達量;分析術中門靜脈血hTERT mRNA相對錶達量與結直腸癌患者臨床病理特徵的關繫;均採用t檢驗.對結直腸癌患者異時性肝轉移風險進行單因素和多因素分析.採用Log-rank法比較術中門靜脈血hTERT mRNA高錶達組與低錶達組的術後生存率.結果 同時性肝轉移患者術前外週血和術中門靜脈血hTERT mRNA的相對錶達量分彆為8.04±3.79和11.88±4.19,無同時性肝轉移患者術前外週血和術中門靜脈血hTERT mRNA的相對錶達量分彆為4.30±2.81和4.94±3.37,前者均高于後者(t=5.159,8.084;P均＜0.01);異時性肝轉移患者術前外週血和術中門靜脈血hTERT mRNA相對錶達量分彆為7.16±3.08和9.83±2.96,無異時性肝轉移患者術前外週血和術中門靜脈血hTERT mRNA相對錶達量分彆為4.11±2.58和4.56±3.09,前者均高于後者(t=5.648,8.467;P均＜0.01).結直腸癌患者術中門靜脈血hTERT mRNA的錶達在不同腫瘤分化程度、不同腫瘤大小、不同腫瘤浸潤深度、有否淋巴結轉移、有否術後複髮、不同術後生存期患者中差異均有統計學意義(t=2.987,2.281,2.135,5.070,5.431,6.803;P均＜0.05).單因素分析顯示,術前外週血和術中門靜脈血hTERT mRNA錶達均與異時性肝轉移相關(x2=9.522,16.393;P均＜0.01);Cox多因素迴歸分析顯示,以上兩者均是其獨立危險因素(相對危險度分彆為4.286,9.783).術中門靜脈血hTERT mRNA高錶達組患者的術後2和3年的生存率分彆為64.6％和52.3％,低錶達組分彆為91.4％和85.3％;兩組術後2和3年的生存率分彆比較,差異均有統計學意義(x2=5.313,P＜0.05;x2 =8.925,P＜0.01).結論 術中門靜脈血hTERT mRNA的錶達與結直腸癌患者的重要病理特徵及其肝轉移、預後密切相關,其對異時性肝轉移的預測價值比外週血hTERT mRNA高.術中門靜脈血hTERT mRNA可成為結直腸癌患者術後預後的評價指標.
목적 탐토결직장암환자외주혈화문정맥혈적인단립매반전록매(hTERT) mRNA적표체여기간전이급예후적관계.방법 납입2009년1월지2011년4월학진병행근치성수술치료적원발성결직장암환자181례.응용형광정량PCR법검측소유환자술전외주혈화술중문정맥혈적hTERT mRNA상대표체량.소유환자술후수방3년.분별비교동시성간전이(18례)화무동시성간전이(163례)환자,이급이시성간전이(29례)화무이시성간전이(152례)환자적술전외주혈화술중문정맥혈hTERT mRNA적상대표체량;분석술중문정맥혈hTERT mRNA상대표체량여결직장암환자림상병리특정적관계;균채용t검험.대결직장암환자이시성간전이풍험진행단인소화다인소분석.채용Log-rank법비교술중문정맥혈hTERT mRNA고표체조여저표체조적술후생존솔.결과 동시성간전이환자술전외주혈화술중문정맥혈hTERT mRNA적상대표체량분별위8.04±3.79화11.88±4.19,무동시성간전이환자술전외주혈화술중문정맥혈hTERT mRNA적상대표체량분별위4.30±2.81화4.94±3.37,전자균고우후자(t=5.159,8.084;P균＜0.01);이시성간전이환자술전외주혈화술중문정맥혈hTERT mRNA상대표체량분별위7.16±3.08화9.83±2.96,무이시성간전이환자술전외주혈화술중문정맥혈hTERT mRNA상대표체량분별위4.11±2.58화4.56±3.09,전자균고우후자(t=5.648,8.467;P균＜0.01).결직장암환자술중문정맥혈hTERT mRNA적표체재불동종류분화정도、불동종류대소、불동종류침윤심도、유부림파결전이、유부술후복발、불동술후생존기환자중차이균유통계학의의(t=2.987,2.281,2.135,5.070,5.431,6.803;P균＜0.05).단인소분석현시,술전외주혈화술중문정맥혈hTERT mRNA표체균여이시성간전이상관(x2=9.522,16.393;P균＜0.01);Cox다인소회귀분석현시,이상량자균시기독립위험인소(상대위험도분별위4.286,9.783).술중문정맥혈hTERT mRNA고표체조환자적술후2화3년적생존솔분별위64.6％화52.3％,저표체조분별위91.4％화85.3％;량조술후2화3년적생존솔분별비교,차이균유통계학의의(x2=5.313,P＜0.05;x2 =8.925,P＜0.01).결론 술중문정맥혈hTERT mRNA적표체여결직장암환자적중요병리특정급기간전이、예후밀절상관,기대이시성간전이적예측개치비외주혈hTERT mRNA고.술중문정맥혈hTERT mRNA가성위결직장암환자술후예후적평개지표.
Objective To investigate the correlation of the expression of human telomerase reverse transcriptase (hTERT) mRNA in peripheral and portal vein blood to liver metastasis and prognosis of patients with colorectal cancer (CRC).Methods From January 2009 to April 2011,a total of 181 patients diagnosed as primary CRC and received radical resection were enrolled.The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood were detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR).All the patients were followed up for three years after operation.The relative quantitative expression of hTERT mRNA in peripheral blood before operation and intraoperative portal vein blood were compared between patients with synchronous liver metastasis (18 cases) and without synchronous liver metastasis (163 cases); between metachronous liver metastases (29 cases) and without metachronous liver metastases (152 cases).The relationship between the expression of hTERT mRNA in intraoperative portal vein blood and clinicopathological features of patients with CRC was analyzed.The t-test was used.Univariate and Multivariate Cox analysis were used for risk analysis of metachronous liver metastases.Log-rank test was used for comparisons of survival rate between the group with high hTERT mRNA expression in intraoperative portal vein blood during operation and the group with low expression.Results The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood in synchronous liver metastases group (8.04±3.79 and 11.88±4.19) was higher than that of no synchronous liver metastases group (4.30±2.81 and 4.94±3.37,t=5.159 and 8.084; both P＜0.01).The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood in metachronous liver metastases group (7.16±3.08 and 9.83 ± 2.96) was higher than that of no synchronous liver metastases group (4.11±2.58 and 4.56±3.09,t=5.648 and 8.467;both P＜0.01).The hTERT mRNA expression in intraoperative portal vein blood of patients with CRC changed significantly with the differentiated degree of tumor,tumor size,different invasion degree of tumor,lymph node metastasis,recurrence after operation,survival time (t =2.987,2.281,2.135,5.070,5.431 and 6.803,all P＜0.05).Univariate analysis revealed that the expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood both were correlated with postoperative metachronous liver metastases (x2=9.522 and 16.393,both P＜0.01).Multivariate Cox analysis showed that both of them were independent risk factors (relative risk (RR)=4.286 and 9.783).The two-and three-year survival rates of the patients with high hTERT mRNA expression levels in intraoperative portal vein blood were 64.6 ％ and 52.3 ％,and those of low expression group were 91.4 ％ and 85.3 ％,and the differences between two groups in two-and three-year survival rate were statistically significant (x2 =5.313,P＜0.05; x2 =8.925,P＜0.01).Conclusions The expression of hTERT mRNA in intraoperative portal vein blood was closely correlated with the important pathologic features,prognosis and liver metastasis of patients with CRC and its predictive value of postoperative CRC metachronous liver metastases was higher than the expression of hTERT mRNA in preoperative peripheral blood.The hTERT mRNA in intraoperative portal vein blood can be a postoperative prognostic marker of patients with CRC.
