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目的检测胃癌和肠癌患者外周血中生存素(survivin)和细胞角蛋白20(CK20)基因的表达,并探讨其与肿瘤诊断、转移之间的关系。方法取胃癌79例,肠癌101例,癌前病变124例(胃56例,肠68例)及正常对照组50例,用实时定量反转录聚合酶链反应(Real-time RT-PCR)方法检测外周血中CK20和生存素基因的转录情况,并分析其与临床病理因素之间的关系。结果正常对照组未检测到CK20和survivin mRNA的转录;良性病变者survivin mRNA的表达率为11.3%,肿瘤组CK20和survivin mRNA表达率分别为胃癌48.1%、87.3%,肠癌48.5%、72.3%,其阳性率与疾病分期及淋巴转移等相关。survivin mRNA高转录者5年生存率显著低于低转录者(P<0.01)。CK20和survivin mRNA表达阳性率高于CEA、CA19-9。结论CK20和survivn mRNA在胃肠癌患者中过表达,可作为诊断微转移和评估预后的客观指标,其诊断外周血微转移优于CEA和CA19-9,联合检测有更高的判断价值。
Objective To detect the expression of survivin and cytokeratin 20 (CK20) in peripheral blood of patients with gastric cancer and colorectal cancer and to explore its relationship with tumor diagnosis and metastasis. Methods Totally 79 cases of gastric cancer, 101 cases of colon cancer, 124 cases of precancerous lesion (56 cases of stomach and 68 cases of intestine) and 50 cases of normal control group were studied by real-time reverse transcription-polymerase chain reaction (RT-PCR) Methods The transcription of CK20 and survivin gene in peripheral blood was detected and the relationship between them and the clinicopathological factors was analyzed. Results CK20 and survivin mRNA were not detected in normal control group. The expression of survivin mRNA in benign lesions was 11.3%, while the expression rates of CK20 and survivin in tumor tissues were 48.1%, 87.3%, 48.5%, 72.3% , The positive rate and disease stage and lymphatic metastasis related. The 5-year survival rate of survivin mRNA transcripts was significantly lower than that of low transcripts (P <0.01). The positive rates of CK20 and survivin mRNA expression were higher than those of CEA and CA19-9. Conclusions CK20 and survivn mRNA are overexpressed in patients with gastrointestinal cancer and can be used as an objective index in the diagnosis of micrometastasis and prognosis. The diagnosis of peripheral blood micrometastases is superior to that of CEA and CA19-9, and the combined detection of CK20 and survivn mRNA has a higher judgment value.