【摘要】 目的　探讨大肠癌病人外周血中CK2 0mRNA的表达及其临床意义。方法　以CK2 0mRNA为靶基因 ,运用逆转录 聚合酶链反应方法 (RT PCR) ,检测 47例Dukes分期结直肠癌病人及肝转移病人外周血中的大肠癌细胞CK2 0mRNA的表达。结果　 2 0例大肠癌组织标本 ,均有CK2 0mRNA的表达 ;2 0例正常人外周血中均无CK2 0mRNA表达 ;DukesB ,C ,D期病人外周血中CK2 0mRNA阳性率分别为 2 5 0 % (5/2 0 ) ,41 2 % (7/1 7) ,87 5% (7/8) ,各组之间差异显著 (P <0 .0 5)。肝转移者CK2 0mRNA阳性率为 87 5% (7/8) ,无肝转移者阳性率为 30 8% (1 2 /39) (P <0 .0 1 )。肿瘤直径 >5cm者 ,CK2 0mRNA阳性率为 51 6%(1 6/31 ) ,<5cm者阳性率为 1 8 8% (3/1 6) (P <0 .0 5)。CK2 0mRNA阳性率与肿瘤原发部位、年龄、性别无关 (P >0 .0 5)。结论　以CK2 0mRNA为靶基因 ,运用RT PCR检测外周血中的大肠癌细胞 ,具有高度特异性和灵敏度。大肠癌应视为一种全身性疾病 ,血液播散或转移在其自然病程中应视为一种相对早期事件 ,并非只有到了晚期 ,才发生血行转移。外周血中CK2 0mRNA的表达与肝转移及复发有关 ,检测外周血中CK2 0mRNA有助于识别出具有复发或远处转移倾向的高危病人更多还原

【Abstract】 Objective To investigate the expression and clinical significance of CK20 mRNA in peripheral blood of colorectal cancer patients. Methods Using cytokeratin 20 mRNA(CK20 mRNA) as a target gene, the expression of CK20 mRNA in peripheral blood of colorectal carcinoma patients had been examined by RT PCR technique in 47 colorectal carcinoma patients with or without hepatic metastasis. Results CK20 mRNA expression showed in 20 colorectal carcinoma tissues, but none in 20 normal persons’ blood samples. The expression rate of CK20 mRNA was 25.0%(5/20), 41.2%(7/17), 87.5%(7/8) in patients with Dukes stage B,C,D respectively(P<0.05). The positive rate of CK20 mRNA in patients with hepatic metastasis was 87.5%(7/8), in patients without hepatic metastasis was 30.8%(12/39)(P<0.01). CK20 mRNA expression in patients with large tumors(>5?cm)(51.6%,16/31) was more than that in patients with smaller tumors(<5?cm)(18.8%,3/16)(P<0.05). No significant correlation was found between the CK20 mRNA expression and primary tumor site, patient’s sex and age(P<0.05). Conclusions Using CK20 mRNA as a target gene to examine the present of colorectal cancer cell in peripheral blood has sensitivity and specificity. Colorectal carcinoma might be regarded as a systemic disease even in early stage. Hematogenous dissemination may be a relatively early event in colorectal carcinoma natural history, and it does not only occure in advanced stage. The expression of CK20 mRNA in peripheral blood of colorectal cancer patients has correlation with recurrence and hepatic metastasis of the disease, detection of CK20 mRNA may be useful for identifing colorectal cancer patients with high risk of recurrence and hepatic metastasis.更多还原