食管癌根治性放疗前后外周血CK19 mRNA变化的临床意义

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。

Clinical Significance of CK19 mRNA Alteration in Peripheral Blood of Esophageal Cancer Patients Treated with Radiotherapy

Objective： To study the clinical significance of the marker of circulating tumor cells（CTC）,cytokeratin 19（CK19） ex-pression in peripheral blood of esophageal cancer patients treated with radiotherapy.Methods： CK19 mRNA expression was determined using nest RT-PCR in pre-and post-radiotherapy blood of 72 esophageal cancer patients,its associations with radiotherapy response and 2-year progression-free survival（PFS） were further evaluated.Results： The positive expression of CK19 mRNA in pre-and post-radio-therapy were 44.4%（32/72） and 30.6%（22/72）,respectively,the difference was not statistical significance（P=0.085）.Besides,37.5%（12/32） of patients with initially CK-19 mRNA-positive turned negative while 62.5%（20/32） kept positive after radiotherapy,5.0%（2/40） of patients with initially CK-19 mRNA-negative turned positive while 95.0%（38/40） kept negative after radiotherapy.Furthermore,the alteration of pre-and post-radiotherapy CK19 mRNA expression was associated with radiotherapy response,and post-radiotherapy CK19 mRNA expression predicted adverse 2-yaar PFS.Conclusion： The alteration of pre-and post-radiotherapy CK19 mRNA expression maybe a useful biomarker related to radiotherapy response and prognosis of esophageal cancer patients treated with radiotherapy.