Hayama Tamuro, Iinuma Hisae, Watanabe Toshiaki
Department of Surgery, Teikyo University School of Medicine, Tokyo 173-0003, Japan.
Oncol Rep. 2007 Oct;18(4):779-84.
The prediction of peritoneal recurrence in colorectal cancer patients is required for improvement of prognosis. In this study, we focused on establishing a novel rapid RNA direct amplification system with transcription-reverse transcription concerted reaction (TRC) to detect carcinoembryonic antigen (CEA) mRNA in peritoneal washings, and its usefulness as a prophylactic tool for peritoneal recurrence and survival in patients with colorectal cancer. Peritoneal washes were obtained from 161 patients with colorectal cancer during laparotomy. CEA mRNA and porphobilinogen deaminase (PBGD) mRNA levels of peritoneal washes were detected using the TRC method. Genetic detection in the CEA mRNA of peritoneal washes by TRC showed a significant correlation to the depth of invasion, lymphatic invasion, venous invasion, lymph node metastasis, peritoneal dissemination and stage. The overall survival and peritoneal recurrence-free survival rates of CEA mRNA-positive patients were significantly poorer than those of marker gene-negative patients. CEA mRNA levels in peritoneal washes were a significant independent prognostic factor for overall survival and peritoneal recurrence-free survival. In conclusion, our study demonstrated that the detection of CEA mRNA in peritoneal washings by TRC is a useful, rapid genetic diagnosis for the prediction of peritoneal recurrence and survival in patients with colorectal cancer.
为改善预后，需要对结直肠癌患者的腹膜复发进行预测。在本研究中，我们致力于建立一种新型的快速RNA直接扩增系统，即转录-逆转录协同反应（TRC），以检测腹膜灌洗液中的癌胚抗原（CEA）mRNA，并评估其作为结直肠癌患者腹膜复发预防工具及生存预测指标的实用性。在剖腹手术期间，从161例结直肠癌患者中获取腹膜灌洗液。使用TRC方法检测腹膜灌洗液中CEA mRNA和胆色素原脱氨酶（PBGD）mRNA的水平。通过TRC对腹膜灌洗液中CEA mRNA进行基因检测，结果显示其与肿瘤浸润深度、淋巴浸润、静脉浸润、淋巴结转移、腹膜播散及分期显著相关。CEA mRNA阳性患者的总生存率和无腹膜复发生存率显著低于标记基因阴性患者。腹膜灌洗液中CEA mRNA水平是总生存和无腹膜复发生存的显著独立预后因素。总之，我们的研究表明，通过TRC检测腹膜灌洗液中的CEA mRNA是一种用于预测结直肠癌患者腹膜复发和生存的有用、快速的基因诊断方法。
