摘要
目的观察结直肠癌组织中K-ras基因突变情况,术前检测患者血清CEA水平,探讨两者与结直肠癌临床病理的关系。方法应用实时荧光定量PCR方法和基因测序技术检测100例结直肠癌组织中K-ras基因12、13密码子突变情况,化学发光法检测患者血清CEA水平,结合其临床病理资料进行统计学分析。结果 K-ras基因突变者39例(39.0%),其中12号密码子突变31例,13号密码子突变8例。有淋巴结转移者K-ras基因突变率(57.8%)明显高于无淋巴结转移者(23.6%),有肝脏转移者K-ras基因突变率(62.5%)明显高于无肝转移者(34.5%),TNM分期Ⅲ、Ⅳ期K-ras基因突变率(56.5%)明显高于Ⅰ、Ⅱ期(24.1%)。K-ras基因突变率与肿瘤大小、部位、肿瘤浸润深度、分化程度无密切关系。49例CEA水平超出正常范围(49.0%)。有淋巴结转移或肝转移患者CEA水平显著高于无淋巴结或肝转移患者(P<0.05)。在肿瘤不同的临床病理分期(Duke's、TNM分期)间CEA水平差异有统计学意义,Duke's D期和TNMⅢ、Ⅳ期出现高阳性率。CEA水平在肿瘤不同浸润深度、体积及分化程度上无明显差异。结论癌组织K-ras基因突变和血清CEA水平超出正常水平预示结直肠癌可能合并淋巴结转移或肝转移,是预后不良的指标。
Objective Todetect mutations ofK-ras gene in cancer tissues and preoperative carci-noembryonic antigen in serums of patients with colorectal cancer,and to find out their correlation with clinical pathological characteristics of colorectal cancer.Methods The specimens of 100 patients with colorectal cancer were collected.Real-time fluorescence quantitative PCR and DNA sequencing were performed in these tissues to detect K-ras gene mutations at codon 12th and codon 13th,and preoperative carcinoembryonic antigen level in serums were evaluated by radioimmunoassay,the results were analyzed with patients＇ clinical pathological data.Results Thirty-nine cases （39.0%） were detected pointmutation,and 31（31.0%）cases were found pointmutation at codon 12th,eight cases（8.0%） at codon 13th.The rate of K-ras gene mutation in cases with metastatic lymph nodes（57.8%） was higher than that in cases with no metastatic lymph node（23.6%）.The mutation rate in cases with liver metastasis（62.5%） was higher than that in cases without liver metastasis（34.5%）,P0.05.And significant differences were found between TNMIII,IV（56.5%） and TNMI,II（24.1%）.There were no closely relationship with size,location,invasive depth and differentiation extent of tumor.CEA levels in 49 patients were positive （more than 5μg/L）.Patients with lymph node or liver metastasis had a high lever of CEA.The positive rate of CEA level in patients with liver/lymph node metastasis was 75% and 73.3% respectively,which was higher than that in patients without liver/lymph node metastasis（44%,29.1%）,P0.05.Significant differences between Duke＇s stages/TNM stages were found with high positive rate in the groups of Duke＇s D stage and TNM III,IV stages.CEA levels had no relationship with size,location,invasive depth or differentiation extent of tumor.Conclusion K-ras gene mutation and CEA level are closely associated with liver and/or lymph node metastasis in colorectal cancer.They are negative prognostic factors of colorectal canc
出处
《中华普通外科学文献（电子版）》
2010年第4期41-44,共4页
Chinese Archives of General Surgery(Electronic Edition)
基金
广州市黄埔科技计划资助项目(2009031)
