【摘要】 目的检测胃癌患者外周血中CK-19和MUC-1的表达,确定其作为早期胃癌微转移分子标志物的可能性;讨论CK-19 mRNA对早期胃癌微转移的临床诊断意义。方法研究对象共分为三组,其中2009年3月～2012年3月期间于陕西省安康市中心医院住院的96例初治胃癌患者作为实验组,30例胃良性疾病患者和30例健康人的外周血分别作为对照组。采用RT-PCR法检测实验组及对照组的外周血中CK-19 mRNA及MUC-1mRNA的表达情况并评估目的基因的表达与临床特征的相关性,对结果进行统计学分析,选取出合适的标本进行PT-QPCR实验。RT-QPCR法检测44例早期胃癌患者外周血中CK-19 mRNA的表达量,通过绘制ROC曲线,探索诊断效果最好的临界值并计算AUC。结果①实验组和对照组中CK-19 mRNA阳性表达率分别为53.13%(51/96)、1.67%(1/60),差异有高度统计学意义(P<0.01),且胃癌组中CK-19 mRNA的阳性表达与肿瘤分期和和分化程度有关;胃癌组和对照组中MUC-1 mRNA阳性表达率分别为61.46%(59/96)、51.67%(31/60),差异无统计学意义(P>0.05)。②本实验结果统计的临界值为0.2358,灵敏度为95.45%,准确度为77.37%;AUC为0.897。结论 RT-QPCR法检测外周血中的CK-19 mRNA,适合作为诊断早期胃癌微转移的重要参考指标。更多还原

【Abstract】 Objective To investigate the expression of CK-19 and MUC-1 in peripheral blood of gastric cancer pa tients by RT-QPCR and discuss the prognostic value.Methods The expression of CK-19 mRNA and MUC-1 mRNA in the peripheral blood of 96 gastric cancer patients from March 2009 to March 2012 in Ankang Contral Hospital,30 non-cancer patients and 30 healthy donors were detected by RT-PCR and found out the positive cases.Then,RTQPCR was used to detect the expression of relative levels of CK-19 mRNA in positive peripheral blood.The accuracy of this trial was analyzed by receiver operating characteristic curve(ROC curve) and the area under ROC curve(AUC).Results ① The expression rates of CK-19 mRNA in the gastric cancer group and the control group were 53.13%(51/ 96) and 1.67%(1/60),with significant difference between them(P < 0.01),and the positive rate of CK-19 was related to TNM classification and differentiation of cancer.The expression rates of MUC-1 mRNA in the two group were 61.46%(59/96) and 51.67%(31/60).So there was no significant difference between them(P > 0.05).②The analysis of ROC curve showed that when the point of transition was 0.2358,its sensitivity and specificity were 95.45% and 77.37% respectively,and the AUC was 0.897.Conclusion The micrometastasis of gastric cancer may be detected through the evaluation of expression of CK-19 mRNA in peripheral blood.更多还原