胃癌患者门静脉血CK20mRNA的检测及其临床意义_0.docVIP

胃癌患者门静脉血CK20mRNA的检测及其临床意义 【摘要】 目的 检测胃癌患者门静脉血细胞角蛋白20(CK20)mRNA，并探讨其临床意义。 方法 采用逆转录聚合酶链反应（reverse transcriptase-polymerase chain reaction， RT-PCR）方法检测30例胃癌患者和10例腹腔良性疾病患者术中门静脉血CK20mRNA。结果 胃癌组门静脉血CK20mRNA检出率53.3%（16/30），对照组门静脉血CK20mRNA均为阴性。胃癌患者门静脉血CK20mRNA检出率与临床TNM期别、有无淋巴结转移相关（P0.05），并与组织分化及肿瘤浸润深度密切相关（P0.01）。结论 胃癌血行转移与有无淋巴结转移及TNM期别有关；与组织分化及浸润深度密切相关；有助于临床采取相应的 治疗 。 【关键词】 胃肿瘤；逆转录聚合酶链反应；细胞角蛋白20；转移 Detection of CK20mRNA in portal venous blood with gastric cancer and its clinical implication XIANG He-ping， ZHANG Chang-le.Department of Surgery， The Affiliated Hospital of Anhui Medical University， Anhui 230000，China 【Abstract】 Objective To detect Cytokeratin20(CK20) mRNA in portal venous blood from patients with gastric cancer and to study its clinical significance. Methods Reverse transcriptase-polymerase chain reaction(RT-PCR) was used to detect the CK20mRNA in portal venous blood from 30 patients with gastric cancer and 10 patients with benign disease who underwent laparotomy served as controls.Results The positive rate of CK20mRNA in portal venous blood was 53.3%， none of 10 patients with benign disease was positive. The positive rate of CK20mRNA in portal venous blood was correlated to the TNM classification and lymph node metastasis（P＜0.05），and also strongly correlated with the different gastric cancer cell line and the stage of the cancer (P＜0.01).Conclusion Metastasis in blood was correlated to lymph node metastasis and TNM classification， and also strongly correlated to the different gastric cancer cell line and the stage of the cancer； and it can be helpful to the therapy. 【Key words】 stomach neoplasm；reverse transcriptase-polymerase chain reaction；cytokeratin 20；metastasis 胃癌根治术后，血行转移是主要死亡原因之一，因此术前及术中早期检出血液中的癌细胞进而采取有效的阻断治疗，是提高疗效的关键，RT-PCR检测具有高度敏感性和特异性，可在106～107个正常细胞中检测出1个癌细胞，被认为是 目前 检测微转移的最有效方法\[1\]。成功的肿瘤微转移的检测取决于是否具有适当的肿瘤标记物。细胞角蛋白20（CK20）由Moll\[2\] 等于1990 年发现，含42 个氨基酸，分子量为48553 ，等电点为566 ，为酸性CK。不同于其他CK ，CK20 具有更为严格的上皮组织特异性，在正常组织中CK20 见于胃黏膜、幽门腺体细胞