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目的消化道恶性肿瘤微转移的诊断一直是临床难题之一,外周血是早期转移阶段肿瘤细胞播散的最主要途径,而选择合适的检测指标尤为重要。本研究旨在应用受试者工作特征曲线(receiver operating characteristiccurre,ROC)分析探讨人外周血端粒酶逆转录酶mRNA(human telomerase reverse transcriptase mRNA,hTERT mRNA)和MUC1 mRNA检测对结直肠癌微转移的诊断价值。方法用实时定量荧光逆转录聚合酶链反应(real-time fluorescentquantitative reverse transcriptase polymerase chain reaction,RT-PCR)方法对53例结直肠癌患者及21例健康体检者外周血标本进行检测,应用受试者ROC对hTERT mRNA、MUC1mRNA检测结果进行分析评价。结果结直肠癌组外周血hTERTmRNA和MUC1 mRNA表达水平(13.99±7.76,43.09±29.98)显著高于正常对照组(0.48±0.39,3.53±4.79),差异具有统计学意义(P均<0.001)。hTERTmRNA表达与肿瘤淋巴结转移、血行转移和TNM分期相关(P=0.024,0.036、0.017)。MUC1mRNA表达与肿瘤淋巴结转移、血行转移和TNM分期相关(P=0.034、0.014、0.011)。结直肠癌患者的hTERTmRNA和MUC1 mRNA在ROC下面积分别为0.91和0.89。hTERT mRNA和MUC1 mRNA对结直肠癌的临床诊断临界点均为Ct≤32。结论通过ROC评价hTERTmRNA和MUC1 mRNA,可作为结直肠癌微转移的诊断标识物。
The purpose of the diagnosis of gastrointestinal cancer micrometastasis has been one of the clinical problems, peripheral blood is the most important means of tumor cell dissemination in the early stage of metastasis, and select the appropriate detection of indicators is particularly important. This study aimed to investigate the effect of human telomerase reverse transcriptase (mRNA) and MUC1 mRNA on the micrometastasis of colorectal cancer using receiver operating characteristic curve (ROC) The diagnostic value. Methods Real-time fluorescent quantitative reverse transcriptase polymerase chain reaction (RT-PCR) was used to detect peripheral blood samples of 53 patients with colorectal cancer and 21 healthy subjects. The subjects ROC analysis of hTERT mRNA, MUC1 mRNA results were analyzed. Results The expression levels of hTERT mRNA and MUC1 mRNA in peripheral blood of colorectal cancer patients (13.99 ± 7.76, 43.09 ± 29.98) were significantly higher than those of normal controls (0.48 ± 0.39, 3.53 ± 4.79, P <0.001). The expression of hTERT mRNA was correlated with lymph node metastasis, hematogenous metastasis and TNM stage (P = 0.024,0.036,0.017). MUC1 mRNA expression correlated with tumor lymph node metastasis, hematogenous metastasis and TNM stage (P = 0.034, 0.014, 0.011). The area under the ROC for hTERT mRNA and MUC1 mRNA in patients with colorectal cancer were 0.91 and 0.89, respectively. The critical point of clinical diagnosis of colorectal cancer with hTERT mRNA and MUC1 mRNA were both Ct≤32. Conclusion The expression of hTERT mRNA and MUC1 mRNA can be evaluated by ROC as a diagnostic marker for micrometastasis of colorectal cancer.