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目的:应用实时荧光定量PCR技术检测结直肠癌腹腔内CEA水平并探讨其临床意义。方法:2003年5月至2004年3月,收集在日本爱知癌症中心手术107例结直肠癌病例的腹腔冲洗液,每个样本的cDNA应用随机引物合成,并在罗氏的实时荧光定量PCR(LightCycler)上进行定量分析。每个样本同时进行常规细胞学检查。所有病例术后经过平均为1年的随访。结果:CEAmRNA的阳性率和水平均与肿瘤的侵润度(T),分期以及淋巴结转移相关。在一个合理界定值上,CEA和CK-20检测的敏感度与特异度均为100%和100%,而常规的细胞学检查则为33%和100%。结论:CEA定量分析是检测结直肠癌腹腔微转移的敏感和特异的方法,CEAmRNA水平的异常与术后的无瘤生存率显著相关。其临床意义有待于更长期的随访结果。
Objective: To evaluate the clinical significance of CEA in colorectal cancer by real-time fluorescence quantitative PCR. METHODS: From May 2003 to March 2004, 107 patients with colorectal cancer undergoing surgery in the Aichi Cancer Center in Japan were enrolled. The cDNA of each sample was synthesized by random primers and analyzed by Roche’s real-time fluorescence quantitative PCR LightCycler) for quantitative analysis. Each sample was subjected to routine cytology at the same time. All cases after an average of 1 year follow-up. Results: The positive rate and level of CEA mRNA were correlated with the tumor invasion (T), stage and lymph node metastasis. At a reasonable cutoff, the sensitivity and specificity of the CEA and CK-20 tests were 100% and 100%, compared with 33% and 100% for routine cytology. Conclusion: CEA quantitative analysis is a sensitive and specific method for the detection of peritoneal micrometastases in colorectal cancer. The abnormality of CEA mRNA level is significantly correlated with the postoperative tumor-free survival rate. Its clinical significance remains to be seen in longer term follow-up.