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目的研究结直肠癌患者门静脉血、外周血中p27基因甲基化状态的变化,探讨其与临床病理特征的关系。方法应用甲基化特异性聚合酶链反应分析技术,检测106例结直肠癌患者的门静脉血中p27基因启动子甲基化的阳性率,并结合临床病理进行分析。结果结直肠癌患者外周血中的p27基因甲基化阳性率为24.5%(26/106),对照组为3.4%(1/29)。结直肠癌患者门静脉血中p27基因甲基化阳性率为30.2%(32/106),其中Dukes分期:A+B期和C+D期阳性率分别为20.0%(11/55)和41.2%(21/51);低分化和高中分化阳性率分别为48.0%(12/25)和24.7%(20/81);有无淋巴结转移阳性率分别为41.5%(17/41)和23.1%(15/65);浸润深度:未达浆膜层和达浆膜层阳性率分别为24.1%(7/29)和32.5%(25/77)。门静脉血中p27基因甲基化与结直肠癌患者的临床分期、组织分化程度及有无淋巴结转移均有关(P<0.05),但与患者的性别、年龄、肿瘤部位和大小均无统计学意义(P>0.05)。结论结直肠癌的发生发展与p27基因甲基化有关。检测结直肠癌患者门静脉血中p27基因甲基化程度,可为临床分期及预后的判断提供依据。
Objective To study the methylation status of p27 gene in portal vein blood and peripheral blood in patients with colorectal cancer and to investigate its relationship with clinicopathological features. Methods Methylation-specific polymerase chain reaction (PCR) was used to detect the positive rate of methylation of p27 gene in portal vein of 106 patients with colorectal cancer. The positive rate of p27 gene promoter methylation was analyzed by clinicopathological analysis. Results The positive rate of p27 gene methylation in peripheral blood was 24.5% (26/106) in colorectal cancer patients and 3.4% (1/29) in control subjects. The positive rate of p27 gene methylation in portal vein of patients with colorectal cancer was 30.2% (32/106). The positive rates of Dukes stage in A + B and C + D were 20.0% (11/55) and 41.2% (21/51). The positive rates of poor differentiation and high differentiation were 48.0% (12/25) and 24.7% (20/81), respectively. The positive rates of lymph node metastasis were 41.5% (17/41) and 23.1% 15/65); depth of invasion: The positive rates of sub-serosa and serosa were 24.1% (7/29) and 32.5% (25/77), respectively. The methylation of p27 gene in portal vein was correlated with clinical stage, histological differentiation and lymph node metastasis (P <0.05), but not with gender, age, tumor location and size (P> 0.05). Conclusion The occurrence and development of colorectal cancer are related to the methylation of p27 gene. Detecting the degree of methylation of p27 gene in portal vein of patients with colorectal cancer can provide evidence for clinical staging and prognosis.