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目的探讨胃癌患者腹液中CK20 mRNA检测的临床意义。方法用实时荧光定量逆转录聚合酶链式反应检测49例胃癌患者腹水或腹腔冲洗液CK20 mRNA的表达情况并以同期10例行非肿瘤手术患者作为对照,结合临床病理资料及随访结果进行分析。结果腹水CK20 mRNA阳性率50.00%,腹腔冲洗液CK20 mRNA阳性率35.90%,两者差异无统计学意义(P>0.05)。胃癌组CK20mRNA表达总阳性率38.78%,对照组均无阳性表达(P<0.05)。胃癌组CK20 mRNA检测阳性率显著高于病理细胞学检查阳性率(10.20%)(P<0.05);CK20 mRNA表达与有无淋巴结转移及肿瘤浸润深度相关(均P<0.05),与组织分化程度无关(P>0.05)。CK20 mRNA阳性表达者的平均生存时间较阴性者显著缩短(20.95个月vs.33.24个月)(P<0.01)。结论胃癌患者腹水或腹腔冲洗液中CK20 mRNA检测,可早期诊断腹腔微转移,有助于判断预后,指导治疗。
Objective To investigate the clinical significance of detecting CK20 mRNA in gastric juice in patients with gastric cancer. Methods The expression of CK20 mRNA in ascites or peritoneal wash fluid of 49 patients with gastric cancer was detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR) and compared with 10 patients with non-tumor surgery in the same period. The clinical data and follow-up results were analyzed. Results The positive rate of CK20 mRNA in ascites was 50.00%. The positive rate of CK20 mRNA in peritoneal washings was 35.90%. There was no significant difference between the two groups (P> 0.05). The positive rate of CK20mRNA in gastric cancer group was 38.78%, but not in the control group (P <0.05). The positive rate of CK20 mRNA in gastric cancer group was significantly higher than that of pathological cytology (10.20%) (P <0.05). The expression of CK20 mRNA was correlated with lymph node metastasis and depth of tumor invasion (all P <0.05) Not related (P> 0.05). The mean survival time of CK20 mRNA positive patients was significantly shorter than that of negative ones (20.95 months vs.33.24 months) (P <0.01). Conclusions The detection of CK20 mRNA in ascites or peritoneal washings in patients with gastric cancer can diagnose peritoneal micrometastases early and help to judge the prognosis and guide the treatment.