【摘要】 目的　检测胃肠道恶性肿瘤止凝血分子标志物血浆含量及mRNA水平 ,探讨其与肿瘤浸润、播散的关系及检测的临床意义。方法　采用逆转录实时定量PCR技术检测 2 9例胃癌、2 3例肠癌患者组织中组织因子 (TF)、组织型纤溶酶原激活剂 (t PA)、尿激酶型纤溶酶原激活剂 (u PA)mRNA水平 ;用ELISA法同步检测患者血浆止凝血分子标志物含量 ,包括TF、凝血酶抗凝血酶复合物 (TAT)、t PA、u PA、u PA受体 (u PAR)、纤溶酶 抗纤溶酶复合物 (PAP)等。结果　术前恶性肿瘤组血浆TF、TAT、u PA、u PAR、PAP含量均较正常对照明显升高 (P <0 0 5 ) ,其中 ,有局部浸润、淋巴结肿大、远处脏器转移者u PA、u PAR升高更为显著 (P <0 0 1) ;TF、u PAmRNA在肿瘤细胞表达显著增高 (P <0 0 1) ,而t PAmRNA(P >0 0 5 )则减少。结论　凝血、纤溶功能亢进是胃肠道恶性肿瘤细胞易播散、浸润的主要原因之一。t PAmRNA的表达可能为组织分化较好的特征。逆转录实时定量PCR技术 ,使TF、u PAmRNA有望作为胃肠道恶性肿瘤病情监测指标而用于临床更多还原

【Abstract】 Objective To study the changes of hemostatic molecular markers in patients with gastric or intestinal cancer for elucidating their clinical significance. Methods The plasma levels of tissue factor(TF)、thrombin antithrombin complex (TAT)、tissue plasminogen activator (t-PA)、urokinase plasminogen activator (u-PA)、urokinase plasminogen activator receptor (u-PAR) and plasim antiplasim complex (PAP) were measured by ELISA . Gene transcription of TF、t-PA、u-PA mRNA were detected by real-time RT-PCR. Results The plasma levels of TF、TAT、u-PA、u-PAR and PAP were elevated in gastric or intestinal cancer patients ( P <0.05) ,while u-PA、u-PAR remarkably increased in patients with local infiltration、lymph node involvement or distal metastasis ( P <0.01). Plasma level of TF、TAT、PAP were remained higher than control even after surgery. TF、u-PA mRNA were higher ( P <0.01) and t-PA was lower( P >0.05) in gastric or intestinal cancer compared to normal tissue. Conclusions Their existed over expression of TF and u-PA、 increasing formation of thrombin and plasminogen in gastric or intestinal cancer patients. Hypercoagulability and hyperfibrinolysis were important factors related with metastasis potential of gastric or intestinal cancer. t-PA may be a character of well differentiated tissue. Quantitative detection of TF and u-PA gene expression by the method of real-time RT-PCR is feasible for them as observation markers in gastric or intestinal cancer patients.更多还原