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[目的]检测大肠癌患者外周血中survivin mRNA、CEA mRNA表达情况,探求大肠癌早期诊断及早期血道微转移检测的特异、敏感指标。[方法]RT-PCR法检测50例大肠癌患者及50例对照组患者外周血中survivin mRNA及CEA mRNA的表达。[结果]Survivin mRNA和CEAmRNA在大肠癌组的阳性率分别为54.0%(27/50)和62.0%(31/50),与对照组比较有显著性差异(P<0.05);两指标阳性率在大肠癌复发转移组与原发无转移组比较差异有显著性(P<0.01)。两指标阳性表达率与Dukes’分期及有无远处转移有关(P<0.01),而与性别、年龄、肿瘤部位、大体分型、肿瘤大小、组织类型无关(P>0.05)。联合检测的敏感性高于任一单一指标的敏感性(P<0.05),而特异性无显著性差异(P>0.05)。复发转移组双阳性率与原发无转移组比较差异有显著性(P<0.01)。[结论]Survivin mRNA作为大肠癌早期诊断及早期血道微转移的指标具有较好的特异性。联合检测survivin、CEA相对单项指标检测显著提高了检出率,且具有良好的特异性,两者联合检测有助于预测大肠癌患者病情发展及预后评估。
[Objective] To detect the expression of survivin mRNA and CEA mRNA in peripheral blood of patients with colorectal cancer and explore the specific and sensitive indexes for the early diagnosis and early detection of colorectal cancer. [Methods] The expressions of survivin mRNA and CEA mRNA in peripheral blood of 50 patients with colorectal cancer and 50 controls were detected by RT-PCR. [Results] The positive rates of Survivin mRNA and CEA mRNA in colorectal cancer group were 54.0% (27/50) and 62.0% (31/50), respectively, which were significantly different from those in control group (P <0.05) There was a significant difference in the recurrence and metastasis of colorectal carcinoma compared with the primary metastasis (P <0.01). The positive rate of the two markers was correlated with Dukes’ staging and distant metastasis (P <0.01), but not with gender, age, tumor location, general classification, tumor size and type of tissue (P> 0.05). The sensitivity of combined detection was higher than that of any single index (P <0.05), while the specificity was not significantly different (P> 0.05). The positive rate of double positive in the group of recurrence and metastasis was significantly different from that in the primary group without metastasis (P <0.01). [Conclusion] Survivin mRNA has good specificity as an early detection and early hematogenous micrometastasis in colorectal cancer. Combined detection of survivin and CEA relative single index detection significantly increased the detection rate, and has good specificity, combined detection of both can help predict the progression of patients with colorectal cancer and prognosis assessment.