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| 胃癌患者术前外周血鸟苷酸环化酶C mRNA表达与术后复发的关系 |
| 徐雯1,张健锋2,蒯小玲2,张弘2,朱惠君3,毛振彪2*,吴永峰4* |
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(1. 南通大学卫生科, 南通 226000;
2. 南通大学附属医院消化内科, 南通 226000;
3. 南通大学附属医院病理科, 南通 226000;
4. 南通市如皋港人民医院外科, 如皋 226532
*通信作者) |
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| 摘要: |
| 目的 探讨胃癌患者术前外周血鸟苷酸环化酶C信使RNA (guanylate cyclase C, GC-C mRNA)表达与术后复发的关系。方法 收集60例胃癌患者术前外周血和同期门诊15例肠上皮化生、21例异型增生患者以及20例健康体检者外周血标本, 应用实时荧光定量PCR(RFQ-PCR)检测GC-C mRNA的表达, 并分析其与临床病理参数及胃癌术后复发的关系。结果 健康体检者外周血中未检测到GC-C mRNA表达, 肠上皮化生和异型增生患者外周血GC-C mRNA表达阳性率分别为9.5%(2/15)和20.0%(3/21);而胃癌患者术前外周血阳性率为48.3%(29/60), 高于健康体检者及肠上皮化生、异型增生患者(P<0.05)。胃癌患者术前外周血GC-C mRNA表达与肿瘤Laurén分型、临床TNM分期、浸润深度、淋巴结转移和分化程度等均有关(P<0.05, P<0.01)。GC-C阳性胃癌患者术后1~4年的累计肿瘤复发率分别为41.4%、79.3%、96.6%和100.0%;GC-C阴性患者术后1～4年的累计肿瘤复发率分别为16.1%、41.9%、67.7%和80.6%, 且GC-C阳性患者术后中位复发时间短于GC-C阴性患者。两组患者术后1~4年的累计肿瘤复发率、中位复发时间和总体生存期差异有统计学意义(P<0.05, P<0.01)。结论 胃癌患者术前外周血GC-C mRNA阳性者预后更差, 且更易出现术后短期复发。 |
| 关键词: 胃肿瘤 鸟苷酸环化酶C 复发 存活率分析 |
| DOI：10.3724/SP.J.1008.2014.01387 |
| 投稿时间：2014-07-25修订日期：2014-11-28 |
| 基金项目: |
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| Correlation of preoperative guanylate cyclase C mRNA in peripheral blood with postoperative gastric cancer recurrence |
| XU Wen1,ZHANG Jian-feng2,KUAI Xiao-ling2,ZHANG Hong2,ZHU Hui-jun3,MAO Zhen-biao2*,WU Yong-feng4* |
(1. Health Department of Nantong University, Nantong 226000, Jiangsu, China;
2. Department of Gastroenterology, Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu, China;
3. Department of Pathology, Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu, China;
4. Department of Surgery, People's Hospital of Rugao Port, Rugao 226532, Jiangsu, China
*Corresponding authors) |
| Abstract: |
| Objective To explore the correlation of preoperative guanylate cyclase C (GC-C) mRNA in peripheral blood with postoperative gastric cancer recurrence. Methods The preoperative blood samples were collected from 60 patients with gastric cancer(GC) before operation, also from 21 patients with dysplasia, 15 with intestinal metaplasia, and 20 healthy volunteers during the same period. GC-C mRNA in the peripheral blood samples was assessed by real-time fluorescent quantitative PCR (RFQ-PCR). The association of peripheral blood GC-C mRNA expression with pathological parameters and gastric cancer recurrence was analyzed. Results The positive rate of preoperative GC-C mRNA in blood samples of gastric cancer patients (48.3% [29/60]) was significantly higher than that of patients with dysplasia (20.0%[3/21], P<0.05) and those with intestinal metaplasia (9.5%[2/15], P<0.05); GC-C mRNA was not detected in healthy controls. The preoperative blood GC-C mRNA in gastric cancer patients were significantly correlated with Laurén type, clinical TNM stage, depth of invasion, lymph metastasis, and differentiation degree (P<0.05 or 0.01). The 1-year, 2-year, 3-year, and 4-year cumulative recurrence rates of GC-C positive patients were 41.4%, 79.3%, 96.6%, and 100.0%, respectively; and those of GC-C negative patients were 16.1%, 41.9%, 67.7%, and 80.6%, respectively. The median recurrence time in GC-C positive patients was significantly shorter than that in GC-C negative patients(P<0.01). The 1-4 years of cumulative recurrence rates and overall survival time were significantly different between the two groups after surgery (P<0.05 or 0.01). Conclusion The preoperative presence of GC-C mRNA in the peripheral blood of gastric cancer patients is related to poor prognosis and early recurrence after surgery. |
| Key words: stomach neoplasms guanylate cyclase C recurrence survival analysis |
