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目的:研究检测食管癌根治性放疗前后外周血中循环肿瘤细胞(circulating tumor cells,CTC)标记细胞角蛋白19(Cytokeratin19,CK19)mRNA的变化及其临床意义。方法:收集72例食管癌患者根治性放疗前后外周血,应用巢式RT-PCR检测CK19 mRNA的表达,分析其与放疗疗效及两年无进展生存(progerssion-free survival,PFS)的关系。结果:放疗前后CK19 mRNA阳性者分别占44.4%(32/72)与30.6%(22/72),差别无统计学意义(P=0.085)。放疗前32例表达阳性者,放疗后其中12例转阴(37.5%),20例持续阳性(62.5%);40例阴性者,2例转为阳性(5.0%),38例持续阴性(81.2%)。并且,放疗前后CK19 mRNA变化与放疗疗效相关,放疗后CK19 mRNA阳性提示2年无进展生存期较差。结论:食管癌根治性前后外周血CK19 mRNA变化对于判断放疗疗效及预后具有重要意义。
Objective: To study the changes of cytokeratin 19 (CK19) mRNA in peripheral blood of patients with esophageal cancer before and after radical radiotherapy and its clinical significance. Methods: The peripheral blood samples of 72 patients with esophageal cancer before and after radical radiotherapy were collected. The expression of CK19 mRNA was detected by nested RT-PCR, and the relationship between the expression of CK19 mRNA and the efficacy and the two-year progression-free survival (PFS) was analyzed. Results: The positive rates of CK19 mRNA before and after radiotherapy were 44.4% (32/72) and 30.6% (22/72) respectively, with no significant difference (P = 0.085). Twelve cases were negative before radiotherapy (37.5%) and 20 cases were persistent (62.5%) after radiotherapy; 40 cases were negative, 2 cases were positive (5.0%), 38 cases were persistent %). And, before and after radiotherapy CK19 mRNA changes associated with radiotherapy efficacy, CK19 mRNA positive radiotherapy after 2 years showed no progress in poor survival. Conclusion: The changes of CK19 mRNA in peripheral blood of patients with esophageal carcinoma before and after radical resection have important significance in judging the curative effect and prognosis of radiotherapy.