Na Guang-Wei, Li Jun, He Ke-Ji, Li Hong-Hua, Zhao Xiao-Ning, Li Xing-Wen, Mi Hai-Ning
Department of Abdominal Surgery Gansu Provincial Tumor Hospital, Lanzhou, Gansu 730 050, P.R. China.
Ai Zheng. 2004 Nov;23(11):1350-3.
BACKGROUND & OBJECTIVE: Detecting expression levels of cytokeratin 19 (CK19), CK20, MUC1, and carcinoembryonic antigen (CEA) in peripheral blood,lymph node,and bone marrow is a major method for diagnosing micro-metastasis in patients with gastrointestinal carcinoma of early stages. This study was to examine the expression, before and after operation, of CK20 mRNA in peripheral blood of patients with gastrointestinal carcinoma, to further explore hematogenous-spread micro-metastasis status of these patients, and significance of CK20 mRNA detection in treatment during perioperation period.
Peripheral blood samples were collected before, and 2 weeks after operation from 62 patients with gastrointestinal carcinoma,and 22 controls (12 patients with benign gastrointestinal disease, and 10 healthy volunteers). CK20 mRNA expression in the blood samples was specifically detected by nested reverse transcriptase-polymerase chain reaction (RT-PCR). Pathologic examination of all cases was done by conventional methods.
Of 62 patients with gastrointestinal carcinoma, 34 (54.3%) have positive CK20 mRNA expression before operation,and so did 31 (50.0%) postoperatively, but no CK20 mRNA expressed in 22 controls. In patients of stageI-IV, CK20 mRNA positive rates were 37.5% (3/8), 36.3% (8/22), 66.7% (18/27), and 100% (5/5), respectively, difference between stage I+II (36.9%) and stage III+IV (83.3%) was significant (P< 0.05). Among 35 patients with local lymph node metastasis, 27 (77.1%) were positive for CK20 mRNA; among 27 patients without lymph node metastasis, 7 (25.9%) have positive CK20 mRNA expression (P< 0.01). CK20 mRNA expression was not correlated with tumor cell differentiation,and cancer embolus existance. There was no significant difference in CK20 mRNA expression before and after operation (P >0.05).
CK20 mRNA may be a sensitive marker for detecting micro-metastasis,and recurrence of patients with gastrointestinal carcinoma. It may be helpful for the correct clinical staging,and reasonable treatment for patients.
检测细胞角蛋白19（CK19）、细胞角蛋白20（CK20）、黏蛋白1（MUC1）和癌胚抗原（CEA）在外周血、淋巴结及骨髓中的表达水平是诊断早期胃肠癌患者微转移的主要方法。本研究旨在检测胃肠癌患者外周血中CK20 mRNA术前及术后的表达情况，进一步探讨此类患者血行播散微转移状态及CK20 mRNA检测在围手术期治疗中的意义。
收集62例胃肠癌患者及22例对照者（12例良性胃肠疾病患者和10例健康志愿者）术前及术后2周的外周血样本。采用巢式逆转录-聚合酶链反应（RT-PCR）特异性检测血样中CK20 mRNA的表达。所有病例均采用常规方法进行病理检查。
62例胃肠癌患者中，术前34例（54.3%）CK20 mRNA表达阳性，术后31例（50.0%）阳性，而22例对照者均无CK20 mRNA表达。Ⅰ-Ⅳ期患者中，CK20 mRNA阳性率分别为37.5%（3/8）、36.3%（8/22）、66.7%（18/27）和100%（5/5），Ⅰ+Ⅱ期（36.9%）与Ⅲ+Ⅳ期（83.3%）之间差异有统计学意义（P<0.05）。35例有局部淋巴结转移的患者中，27例（77.1%）CK20 mRNA阳性；未发生淋巴结转移的27例患者中，7例（25.9%）CK20 mRNA表达阳性（P<0.01）。CK20 mRNA表达与肿瘤细胞分化及癌栓存在无关。手术前后CK20 mRNA表达差异无统计学意义（P>0.05）。
CK20 mRNA可能是检测胃肠癌患者微转移及复发的敏感标志物。对患者正确的临床分期及合理治疗可能有帮助。
