目的分析外周血中癌胚抗原信使核糖核酸(CEA mRNA)在诊断胃癌血行转移中的应用价值,评价抗癌中药华蟾素对胃癌的疗效。方法将Ⅲb~Ⅳ期晚期胃癌患者随机分为治疗组和对照组。2组均采用口服替吉奥胶囊方案化疗2个周期,替吉奥80mg·m-2·d-1,每天2次,于早饭后和晚饭后各服1次,连服14d,停药7d,3周为1个周期;治疗组在化疗同时加用华蟾素注射液20mL+5%葡萄糖注射液500mL,每日1次,连用14d。应用反转录-聚合酶链反应技术(RT-PCR)检测患者运用药物前后外周血CEA mRNA的含量。结果胃癌患者治疗前,治疗组CEA和CEA mRNA阳性率分别为34%、62%;对照组分别为32%、58%,2组间含量差异均无统计学意义。治疗后,对照组患者CEA和CEA mRNA的阳性率分别为28%、49%;治疗组分别为27%、44%(P>0.05),治疗组治疗前后CEA与CEA mRNA含量差异有统计学意义(P<0.05),2组间治疗后CEA含量差异无统计学意义,CEA mRNA含量差异有统计学意义(P<0.05)。结论 CEA mRNA的表达可能与肿瘤微转移相关,采用反转录-聚合酶链反应(RT-PCR)方法检测外周血中CEA mRNA的表达,可能是一种较理想的预测方法;抗癌中药华蟾素联合化疗用药可有效治疗胃癌。 Objective To analyze the value of carcinoembryonic antigen messenger RNA (CEA mRNA) in the diagnosis of hematogenous metastasis of gastric cancer and evaluate the curative effect of anticancer Chinese cinobufacini on gastric cancer. Methods Patients with stage Ⅲb-Ⅳ advanced gastric cancer were randomly divided into treatment group and control group. The two groups were treated with oral administration of Teglitazone for 2 cycles of chemotherapy, 80 mg · m-2 · d-1 for 2 times a day. After breakfast and after dinner, , 3 weeks for a cycle; the treatment group while adding cinobufotalin injection 20mL + 5% glucose injection 500mL, once daily for 14d. The levels of CEA mRNA in peripheral blood of patients before and after using drugs were detected by reverse transcription-polymerase chain reaction (RT-PCR). Results Before treatment, the positive rates of CEA and CEA mRNA in treatment group were 34% and 62%, respectively. There were no significant differences in the content of CEA and CEA mRNA in the control group between the two groups (32% and 58%, respectively). After treatment, the positive rates of CEA and CEA mRNA in the control group were 28% and 49% respectively; the treatment group was 27% and 44% respectively (P> 0.05), the difference of CEA and CEA mRNA in the treatment group before and after treatment was statistically significant (P <0.05). There was no significant difference in CEA content between the two groups after treatment, but the difference was statistically significant (P <0.05). Conclusions The expression of CEA mRNA may be related to tumor micrometastasis. The detection of CEA mRNA in peripheral blood by reverse transcription-polymerase chain reaction (RT-PCR) may be an ideal method for predicting the expression of CEA mRNA. Cinobufotalin combined with chemotherapy can effectively treat gastric cancer.