大肠癌患者腹腔冲洗液CEA、GCC和CD44v6转录本的检测及其临床意义王浩斌'，张才全'，王崇树S赵明才'，谢贤雍°,侯华芳2('重庆页科大学附属第一医院普通外科，重庆400016：川北医学院：1■'附属医院普外一科，彳风湿免疫研究所，"附属医院病理科，四川南充637000)摘要：目的探讨检测大肠癌想者术中腹腔冲洗液CEA.GCC和CD44v6niRNA表达的临床意义。方法收集60例大肠肿瘤患者的术中腹腔冲洗液,其中大肠癌48例(大肠癌组),大肠良性病变12例(阴性对照组),以上标本均经病理学证实，并以人大肠癌细胞株SW480作为阳性对照：应用基于b-DNA信号放大的基因表达定昴:检测技术测定腹腔冲洗液中脱落细胞的CEA、GCC和CD-1-1V6mRNA表达，同时作腹腔冲洗液细胞学检查(PLC),进而结合临床相关资料分析CEA、GCC和CI)11v6腻NA表达的临床意义。结果大肠癌组腹腔冲洗液CEA、GCC.CI)44v6的表达阳性率分別为43.8%(21/48).60.4%(29/48).31.3%(15/48),总阳性率为72.9%(35/48),高于腹腔冲洗液PLC的阳性率4.2%(2/48),上述3项指标在人大肠癌细胞株SW480中表达均为阳性：在阴性对照组中有1例CEAmRNA检出阳性，其余均为阴性表达。CEA、GCC和CD44v6mRNA的阳性率与Dukes分期、肿痫分化程度、浆膜侵犯程度、淋巴结转移有统计学差异(P<0.05),与肿瘤大小、患者年龄和性别无统计学差异(P>0.05)o结论检测腹腔冲洗液中CEA>GCC和CDllv6mRNA的表达有助于大肠癌腹腔微转移的预测及术后治疗方案的制定；GCC、CD11V6与CEA一样，可作为检测大肠癌腹腔脱落癌细胞的指标；基于b-I)NA信号放人的基因表达定量检测技术对于检测腹腔脱落癌细胞的敏感性和特异性显著高于PLC,是一种预测腹腔微转移的有效方法。关键词：结直肠肿瘤；肿瘤微转移；腹腔冲洗液;CEA；GCC；CD44v6；b-DNA；QuantiGene2.0中图法分类号：R735.3+4；R73-34；R73-37文献标识码：ADetectingCEA,GCCandCD44v6mRNAinperitonealwashingsofcolorectalcancerpatientsandtheirclinicalsignificanceWANGHao-bin1,ZHANGCai-quan1,WANGChong-shu2,ZHAOMing-cai3,XIEXian-yong4,HOUHua-fang*(*ThirdDepailmentofGeneralSurgery;FirstAffiliatedHospital,ChongqingUniversityofMedicalSciences,Chongqing,400016,China：2FirstDepartmentofGeneralSurgery,AffiliatedHospital,NorthSichuanMedicalCollege,Nanchong,637000,China：ResearchInstituteofRheumatologyandImmunology,NorthSichuanMedicalCollege,Nanchong,637000,China：4Departmentmentofpathology,AffiliatedHospital,NorthSichuanMedicalCollege,Nanchong,637000,China)Abstract：ObjectiveToexplorethesignificanceofdetectingthetranscriptsofCEA,GCCandCD44v6inperitoneallavagesofcolorectalcancerpatients.MethodsTheperitoneallavagesof48patientswithcolorectalcancer(colorectalcancergroup)and12patientswithbenigncolorectaldisease(negativcontrolgroup)werecollected.Allofthepatientswerepathologicallyconfirmed.HumancolorectalcancercelllineSW480weretakenasapositivecontrol.ThemRNAlevelofCEA,GCCandCD44v6incollectedcellsweredetectedbyQuantiGeneReagentSystem,whichisaquamitativeRNAdetectionmethodbasedonbranchedDNA(b-DNA)signalamplificationtechnique・Meanwhile,cytologicexaminationwithmicroscopewasperformed.ResultsThepositiveexpressionratesofCEA,GCCandCD44v6inperitoneallavageswere43.8%(21/48),60.4%(29/48)and31.3%(15/48),thetotalpositiveratewas72.9%(35/48)incolorectalcancergroup,whichwasmoresensitivethanthatofcytologicexamination(2%,1/48)；AllthreemarkergeneswereexpressedinhumancolorectalcancercelllineSW480・TherewasonlyonesamplepositiveforCEAmRNAinthenegativecontrolgroup.ThepositiverateofCEA,GCCandCD44v6expressionswerecorrekitedwiththeDukesstaging,differentiationstatus,serosalinvolvementandlymphnodemetastasis(P<0.05),butnotwithtumorsize,patientageandgender(P>0.05).ConclusionsThedetectionofCEA,GCCandCD44v6mRNAinperitoneall...