黄梁 王灏 郁宝铭 郑民华 200025 上海，上海第二医科大学附属瑞金医院外科 中国胃肠外科杂志 1999 0 2 3


    关键词：P53基因突变；肿瘤标志物；预后；结直肠肿瘤 期刊 zgwcwkzz 0 论 著 fur -->


    

【摘要 】 目的 进一步了解肿瘤标志物与基因检测在判断结直肠肿瘤患者预后中的价值。方法 对54例结直肠癌患者，术前取血检测结直肠相关抗原血清癌胚抗原(CEA)、CA19-9水平，同时取手术切除标本，应用聚合酶链反应-单链构像多肽性法(PCR-SSCP)检测P53基因第5-8外显子。结果 P53基因突变率为44.4%(24/54)，在P53基因突变患者中，CEA阳性率明显高于P53基因未突变者(P<0.05)，而术前CEA(+)及肿瘤标本P53基因突变者多发生复发或远处转移(P<0.05)。结论 术前CEA(+)及肿瘤标本中P53基因突变者临床预后差，这不但说明了术前测定肿瘤标志物同样存在临床实用价值，而且对于术后如何制订合理的、优化的治疗方案、如何进一步有效地加强临床随访工作均有一定的参考价值。

The prognosticsignificance of P53 gene mutation and preoperative serum levels of tumor markers incolorectal carcinoma

HUANG Liang, WANG Hao, YU Baoming,et al. Department of Surgery, Ruijin Hospital, Shanghai Second Medical University,Shanghai 200025

【Abstract 】 Objective To further demonstrate theclinical significance of P53 gene mutation and serum levels of tumor markers in theprognosis of colorectal carcinoma. Methods Preoperative serum levels of CEA, CA19-9 in 54 patientswith colorectal carcinoma were analyzed. P53 gene mutation in tumor samples was detectedusing polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) at thesame time. Results 24 of 54 patients had P53 gene mutation (44.4%). The rate of raisedserum level of CEA was much higher in mutated patients than those without (41.67% vs.10.00%, P<0.05). Whereas, the patients who had high serum level of CEA preoperativelyand P53 gene mutation in tumor tissue were much more easier to tumor recurrence or distantmetastasis. Conclusion The patients with high serum level of CEA preoperatively and P53gene mutation have a poor prognosis. It not only shows the clinical significance ofdetecting tumor markers preoperatively, but also has a certain evidence of how to work outthe reasonable and suitable regimen in the treatment and follow-up of colorectal carcinomapatients.

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