Detections Of Tissue Ykl-40 MRNA And Plasma Ykl-40 In Colorectal Carcinoma And Their Clinical Applications

Objective:1.To evaluate the clinical applications of plasma YKL-40 and tissue mRNA in colorectal carcinoma.2.To evaluate the possible function of ykl-40 in colorectal carcinoma and the relation of ykl-40,nm23-H1 and wild-typed p53 in carcinogenesis and development of colorectal carcinoma.Methods:1.The real-time fluorescence quality RT-PCR to detect ykl-40,nm23-H1 and p53 mRNA was established and used to detect tissues from 34 colorectal carcinoma patients.2.Plasma YKL-40 was measured in 120 patients referred with primary, recurrent colorectal carcinoma or after clinical surgery therapy and 23 patients referred with colon and rectum benign diseases and 36 healthy subjects using the EIA kit from Quidel company USA .3.Levels of plasma YKL-40 and tissue ykl-40 mRNA were compared in different pathologic appearances including DUKE'S stages, differentiation, lymphoid nodes metastasis, age, cancer embolus. Plasma YKL-40 was compared to CEA ,CA199,CA125,CA724 and FER.Tissue ykl-40 mRNA was compared to nm23-H1 and p53.The statistic methods included t-test, analysis of variance, chi-square test.Results: 1.The PCR products of ykl-40,nm23-H1,p53 andβ-actin were sepcific and fit to the disgn.The PCR efficiency of ykl-40,nm23-H1,p53 andβ-actin were 97%,99%,97% and 98% separately.2.The level of plasma YKL-40 is higher than that of healthy and benign disease ,p<0.050.Area under ROC curve is 0.789 and 72.4ng/ml is the best leak point of YKL-40 in colorectal carcinoma. The sensitivity and specificity are 78.2% and 74.1% separately. The positive rate of YKL-40 in colorectal carcinoma is significantly higher than CEA, CA125, CA199, CA724 and FER.The levels of plasma YKL-40 in primary and recurred colorectal carcinoma patients are higher than that in patients after clinical surgery therapy, p=0.303,<0.050,<0.050 separately. The levels of YKL-40 is significantly higher in carcinoma poorly differentiated than well and moderately differentiated carcinoma p=0.034. YKL-40 is highly expressed with DUKE'S stages, DUKE'S A/B vs DUKE'S C/D has difference significant. Patients with lymph nodes metastasis have higher plasma YKL-40 than lymph nodes metastasis negative patients, p<0.050. The level of plasma YKL-40 in patients with carcinoma bigger than 4*5cm is higher than smaller, p=0.030.3.The level of ykl-40 mRNA is significantly higher in carcinoma poorly differentiated than well and moderately differentiated carcinoma, p=0.013. ykl-40 mRNA is highly expressed with DUKE'S stages, DUKE'S A/B vs DUKE'S C/D has difference significant. Patients with lymph nodes metastasis have higher tissue ykl-40 mRNA than lymph nodes metastasis negative patients, p<0.050. There are no significance both in ykl-40 mRNA and YKL-40 compared to age, sex, cancer embolus and position.Conclusions:1.The real-time fluorescence RT-PCR we established has high efficiency and specificity.2.Plasma YKL-40 can be used in colorectal carcinoma diagnosis, and also be used as a forecast index of recrudesce in colorectal carcinoma patients, and can be used as a monitoring index of surgery therapy,too. Plasma YKL-40 is higher in lymph nodes metastasis, and associated with DUKE'S stages. YKL-40 has higher positive rate than CEA,CA199,CA125,CA724 and FER.3.The level of tissue ykl-40 mRNA is associated with differentiation of cell, lymph nodes metastasis and DUKE'S stages.The expression ykl-40 in tissue of colorectal carcinoma is higher than nm23-H1 and p53 and three of them have some correlation.