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目的探讨门静脉血中微转移对大肠癌病人术后1、2、3年存活率的影响。方法对南昌大学附属第一医院2002年5月至2003年9月间接受手术治疗46例大肠癌病人,采用RT-PCR(逆转录-聚合酶链式反应)方法检测门静脉血中CK20mRNA的表达,所有病人随访3年以上。结果46例大肠癌病人CK20mRNA的阳性率为54.3%(25/46),术后1、2、3年存活率分别为86.5%、70.2%、63.1%;CK20mRNA阳性病人术后1、2、3年存活率分别为74.5%、46.5%、41.9%;阴性病人术后1、2、3年存活率分别为95.2%、85.7%、85.7%,两组比较χ2=11.69,P<0.01,CK20mRNA阳性组存活率低于阴性组。结论门静脉血中微转移的检测可协助评判大肠癌病人的预后,为术后监控及进一步的综合治疗提供参考价值。
Objective To investigate the effect of micrometastasis in portal vein on survival of patients with colorectal cancer at 1, 2 and 3 years after operation. Methods Forty-six patients with colorectal cancer underwent surgery from May 2002 to September 2003 in the First Affiliated Hospital of Nanchang University. The expression of CK20 mRNA in portal vein was detected by reverse transcription-polymerase chain reaction (RT-PCR) All patients were followed up for more than 3 years. Results The positive rate of CK20 mRNA in 46 patients with colorectal cancer was 54.3% (25/46). The survival rates at 1, 2 and 3 years after operation were 86.5%, 70.2% and 63.1% The annual survival rates were 74.5%, 46.5% and 41.9% respectively. The survival rates at 1, 2 and 3 years after operation in the negative patients were 95.2%, 85.7% and 85.7% respectively, withχ2 = 11.69 and P <0.01 Group survival rate was lower than negative group. Conclusion The detection of micrometastasis in portal vein blood can help evaluate the prognosis of patients with colorectal cancer and provide reference value for postoperative monitoring and further comprehensive treatment.