The Experimental Study By Ombined Detection OFCK19mRNA Cea And Ca199in Patients With Colorectal Cancer

Colorectal cancer is one of the most common alimentary canal malignant cancers. In Western developed countries, the incidence of colorectal cancer ranks3rd in all malignant tumors. Recently more an more young people suffered from colorectal cancer as the changing of diet habit and promoting of life level. Modality due to colorectal cancer in Shanghai, Beijing and other big cities in China speeds up much faster than that in western countries. About200,000to300,000died from colorectal cancer in China every year. Surgery, combined with radiotherapy and chemotherapy, is the main treatment for colorectal cancer at present. However, in our country,5-year survival rate of colorectal cancer patients is only about50%which is, at least partly, due to poor diagnosis. Colonoscopy followed with pathological analysis is well known as gold standard in the clinic colorectal diagnosis. However, colonoscopy has limitations:(1) it is an invasive operation, easy to cause gastrointestinal perforation, bleeding and other serious complications. Coloronoscopy can not be applied to patients with poor physical condition.(2) The accuracy colonoscopy is based on tissue sites where are taken and the level of the pathologist. Therefore, looking for simple and good diagnostic marker has very important significance for early diagnosis, prognosis and recurrence evaluation of colorectal cancer.Tumor markers are tumor-produced biochemical substances which can reflect tumor’s existing and growing. Tumor markers are widely used in clinics since its easy detecting, no invasiveness and low cost, etc. More and more data supports that combined detection of several tumor markers significantly improve the sensitivity of tumor diagnosis. Here, we aimed to explore the potential use of combined diagnosis of CK19mRNA serum CEA and CA199. CEA and CA199are widely used in colorectal detection. CK19mRNA has been used for detection of lung cancer and breast cancer metastasis detection and there are few reports of diagnosis and monitoring recurrence of colorectal cancer. Our data here showed great potential for combined detection (CK19mRNA, CEA and CA199) in colorectal cancer diagnosis and monitoring.OBJECTIVE To explore the potential use of combined detection of CK19mRNA, CEA and CA199in clininc diagnosis of colorectal cancerMATERIAL AND METHODS1Cases and patientsA group of76(40male and36female) patients, aged30-82years (mean age of60.2years) were collected from June2008to June2009and diagnosed as colorectal cancer based on pathology According to Dukes stages, there were16cases of A stage,22cases of B stage,38cases of C stage. There are40cases of tubular adenocarcinoma,31cases of papillary adenocarcinoma and other5cases.20healthy blood donors (12male and8female, mean age:37.6years) and35colorectal benign disease patients (19male and16female, with mean age of40.2years) were used as control. Peripheral blood was taken from all cased for further analysis.2MethodsRT-PCR was applied for analysis of CK19mRNA and electrochemical luminescence was involved to detect CEA and CA199levels. SPSS13.0was used for statistically analysis.RESULTS1CK19mRNA, CEA and CA199positive rates is significantly higher in patients with colorectal cancer than that of control groups The positive rates of peripheral blood CK19mRNA and serum CEA, CA199in colorectal cancer group (52.6%,44.7%and23.7%respectively) were significantly higher than that in colorectal benign disease group (8.6%,5.7%and8.6%respectively) and in healthy control group (0.0%,5.0%and5.0%respectively)(p<0.05). There is no statistic difference between patients with benign disease and healthy control group (p>0.05). This indicated that CK19mRNA, CEA and CA199are good tumor markers for colorectal cancer.2The diagnosis efficacy of combined detection of CK19mRNA, CEA and CA199is significantly higher for colorectal cancer Compared with CEA and CA199, the sensitivity of CK19mRNA (52.6%) for colorectal cancer was the highest. Combined detection of two (p<0.05) or three markers (p<0.01) significantly enhanced the diagnositic sensitivity but not the specificity and positive predicative value (p>0.05).3Combined detection of CK19mRNA, CEA and CA199corresponds much well for dukes stages in patients with colorectal cancer Positive rates of combined detection of CK19mRNA, CEA and CA199in each stage were significantly different (p<0.05). Positive rate of combined detection of CK19mRNA, CEA and CA199in patients with duke C stage was significantly higher than that in B stage and A stage (p<0.05).4Combined detection of CK19mRNA, CEA and CA199is helpful for monitoring for colorectal cancer patients Positive rates of CK19mRNA, CEA and CA199combined detection in each period were significantly different with single index (p<0.05). The combined detection has better evaluate for monitoring the treatment effects of colorectal cancer.5Combined detection of CK19mRNA, CEA and CA199significantly decreases the loss of recurrence detection of colorectal cancer patients76colorectal cancer patients with different duke stages were follow-up to24-month. Recurrence rates of patients with CK19mRNA, CEA and CA199detecting positive and negative in the same follow-up period had significant difference. The recurrence rates of colorectal cancer patients of single index and combined detection of CK19mRNA, CEA and CA199had no significant difference (p>0.05). However, combined detecting increased the positive detecting rate of colorectal patients with recurrence. This suggested that combined detection of CK19mRNA, CEA and CA199is valuable in colorectal cancer patients’follow-up.CONCLUSIONCombined detection of CEA, CK19mRNA and CA199are ideal for monitoring colorectal cancer.