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目的 :探讨门静脉血 K- ras、p5 3基因突变与大肠癌肝转移的关系。方法 :应用 PCR- SSCP和 PCR-RFL P方法 ,对大肠癌患者的癌组织、门静脉血、外周静脉血分别进行 K- ras、p5 3基因检测 ,术后随访 2 a,了解肝转移情况。结果 :30例中门静脉血 K- ras基因突变 6例 ,无突变 2 4例 ,术后 2 a内肝转移率分别为 6 6 .7% (4/6 )、16 .7% (4/2 4) ,两者差异有统计学意义 (P<0 .0 2 5 ) ;30例中门静脉血 p5 3基因突变 10例 ,无突变 2 0例 ,术后 2 a内肝转移率分别为 6 0 % (6 /10 )、10 % (2 /2 0 ) ,两者差异有统计学意义 (P<0 .0 0 1)。结论 :检测门静脉血 K- ras、p5 3基因突变对预测大肠癌肝转移 ,判断预后有重要意义。
Objective: To investigate the relationship between the mutation of K5-ras and p53 in portal vein and liver metastasis of colorectal cancer. Methods: K-ras and p5 3 genes were detected in cancer tissue, portal vein blood and peripheral venous blood of patients with colorectal cancer by PCR-SSCP and PCR-RFLP methods respectively. The patients were followed up for 2 years to observe the liver metastasis. Results: The mutation of K-ras in 30 cases of portal vein blood was found in 6 cases without any mutations in 24 cases. The rates of liver metastases within 2 years after operation were 66.7% (4/6) and 16.7% (4/2 4). The difference between the two groups was statistically significant (P <0.05). There were 10 cases of p15 gene mutation in 30 cases of middle portal vein blood with no mutation in 20 cases. The rates of liver metastases within 2 years after operation were 60 % (6/10) and 10% (2/20), respectively, with significant difference between the two groups (P <0.01). Conclusion: The detection of K-ras, p5 3 gene mutations in portal vein blood is important for predicting liver metastasis and prognosis of colorectal cancer.