Research on the prediction of hematogenous metastasis and recurrence of hepatocellular carcinoma, pancreatic carcinoma, gastric carcinoma and esophageal carcinoma. (Detection of circulating AFPmRNA,CEAmRNA and Cytokeratin mRNA)

在本研究中，我们以以下mRNA的形式建立了血液中各种胃肠道癌细胞的检测系统（rt -巢式PCR）。肝癌检测到甲胎蛋白（AFP） mRNA，胰腺癌和胃癌检测到癌胚癌抗原（CEA） mRNA，大肠癌检测到细胞角蛋白20mRNA，食管癌检测到鳞状细胞癌抗原（SCC） mRNA。该系统可在1ml血液中检测到1 ~ 5个癌细胞，磁性细胞吸收后免疫组化可清楚地显示外周血中表达CEA或细胞角蛋白的细胞。我们还检测了胰腺癌患者术中门静脉CEA mRNA和食管癌患者术中外周血SCC mRNA。这些事实表明，在手术过程中，癌细胞可以在血液中播散。血液中癌相关mrna的检测与患者预后及复发相关。有患者化疗后未检测到CEA mRNA或SCC mRNA，但给药方案仍存在争议。我们的血液癌细胞检测系统有助于预测患者的预后，并可能为化疗策略提供有益的信息。对血液中癌细胞阳性患者的临床病理和分子生物学分析应在未来进行评估。

In this study, we established detection system (RT-nested PCR) of various gastrointestinal carcinoma cells in blood in the form of following mRNA.Alpha-fetoprotein(AFP) mRNA for hepatocellular carcinoma, carcinoembrionic carcinoma antigen (CEA) mRNA for pancreatic and gastric carcinoma, cytokeratin 20mRNA for colorectal carcinoma, and squamous cell carcinoma antigen (SCC) mRNA for esophageal carcinoma These systems could detect one to five cancer cells in 1ml of blood and magnetic cell absorption followed by immunohistochemistry clearly demonstrated the cells, which express CEA or Cytokeratin in peripheral blood. We also detected CEA mRNA in portal vein during operations in pancreatic carcinoma patients and SCC mRNA in peripheral blood during operations in patients with esophageal carcinoma. These facts show that carcinoma cells can be disseminated in blood during operations.Detection of carcinoma related mRNAs in blood correlated with patients prognosis and recurrence. There were patients whose CEA mRNA or SCC mRNA was not detected after chemotherapy, however the protocols of drug administration remains controversial. Our detection systems of cancer cells in blood are useful for prediction of patients' prognosis and might have beneficial information for strategy of chemotherapy. Clinicopathological as well as molecular biological analysis of the patients with positive cancer cells in blood should be evaluated in the future.