【摘要】 目的　探讨癌症患者在开始接受治疗时是否已发生血液循环中癌细胞的微转移。方法　以角蛋白 19(K19) mRNA及癌胚抗原 (CEA) mRNA两基因的表达为标记物 ;应用巢式—反转录聚合酶链反应 (Nested RT PCR)进行扩增 ,经PAG后进行观察。结果　结肠癌组 75例患者的门静脉血中肯定有转移者 36例 ( 4 8.0 % ) ;其中 35例之周围血有 8例 ( 2 2 .86 % )为阳性。卵巢癌组 5 0例患者之骨髓测得 2 5例 ( 5 0 .0 % )为阳性 ,其周围血 2 2例中只有 3例 ( 13.6 3% )为阳性 ,2 0例未经化疗之结直肠癌患者作了周围血的复查 ,阳性仍占 2 0 %。结肠癌随临床Duke′s分期早晚其阳性率亦随之上升 ;病理型态分化程度之高低与微转移亦呈正相关。结论　结肠癌、卵巢癌临床早期已有癌细胞发生微转移。单凭手术消灭不了癌细胞 ,必须及早化疗。K19可作为检测卵巢癌的生物指标。而结直肠癌则以K19及CEA联合应用更可靠。标本采集 ,结肠癌以门静脉血 ,卵巢癌以骨髓为首选。更多还原

【Abstract】 Objective To detect the micrometastases in circulating cancer cells.Methods Nested reverse transcription polymerase chain reaction (nested RT PCR) was employed to examine the specific expression of keratin 19(K19) and carcinoembryonic antigen(CEA) mRNA in portal vein blood and bone marrow aspiration specimens.Results Of the 75 cases of colorectal cancer patients′ portal vein and of the 35 collected peripheral blood samples,the expression of K19 and CEA mRNA was positive in 36(48%) and 8(22.86%) cases respectively.25 cases (50%) in 50 ovarian cancer patients showed positive expression of K19 mRNA in bone marrow aspirate and the peripheral blood only 3(13.63%) in 22 samples.Of the 20 colorectal cancer patients untreated with chemotherapy on discharging time,20% remained positive. The increasingly positive rate associated with the Duke′s stage progressing in colorectal cancer and there had a positive relationship between differentiation of pathological type and micrometastases.Conclusion In the early stage,the cancer cells have already metastasized.The treatment should be the combination of operation and chemotherapy which should be carried out as early as possible.K19 and CEA may be used as a valuable biological marker for detecting circulating cancer cells.更多还原