A Clinical Research Of The Radical Hysterectomy’s Impact On The Expression Of CK19and SCCAg In Peripheral Blood

Objective:By detecting the expression of CK19and SCCAg genes in the peripheral blood with qRT-PCR technique, we compared changes of the relative expression quantity and positive rate of CK19and SCCAg genes pre-operation,24hours post-operation and30days post-operation on cervical cancer patients receiving radical hysterectomy, so as to study the influence of this surgery on the expression of CK19and SCCAg genes, fill the gap that imaging, tumor markers and other examinations cannot timely and accurately reflect the property of metastasis, choose a proper adjuvant therapy post-operation and estimate the prognosis.Materials and methods:1.Collect30patients with early (Ⅰ A2～Ⅱ A) cervical cancer as the experimental group,15patients with uterine myoma,15healthy volunteers and15patients with advanced (ⅡB～ⅢB) cervical cancer as the control group, who were all from the department of gynecological tumors in the third affiliated hospital of Kunming medical university. Elbow venous blood samples pre-operation,24hours post-operation and30days post-operation of the experimental group, and the same samples before treatment of the control group were collected. Detect the expression of CK19and SCCAg genes with qRT-PCR technique, and compare changes of the relative expression quantity and positive rate of CK19and SCCAg genes pre-operation,24hours post-operation and30days post-operation on cervical cancer patients receiving radical resection.2. All data were statistically processed by SPSS17.0software. Comparisons of the relative expression quantity of CK19and SCCAg genes pre-operation,24hours post-operation and30days post-operation in the experimental group and the relative expression quantity of CK19and SCCAg genes in the control group were analyzed by Wilcoxon nonparametric rank sum test, while comparisons of the positive rate of CK19and SCCAg genes were analyzed by chi-square test, Fisher test and McNemar paired chi-square test.Results:1. Before operation, there are statistical significant differences in the relative expression quantity of CK19and SCCAg genes in the peripheral blood among patients with early cervical cancer in the experimental group(P<0.001), patients with uterine myoma, healthy volunteers and patients with advanced cervical cancer in the control group.2. Before operation, the positive rate of CK19and SCCAg genes in the peripheral blood of30patients with cervical cancer was30%(9/30) and20%(6/30), respectively. Before operation, combining detection of the expression of these two markers can improve the positive rate to40%. There are statistical significant differences between the positive rate by a combined detection of the expression of these two markers and that by a detection of either single marker.3.Comparisons of the relative expression quantity of CK19and SCCAg genes pre-operation,24hours post-operation and30days post-operation on cervical cancer patients receiving radical resection showed that compared with the relative expression quantity pre-operation, that24hours post-operation increases and the difference has a statistical significance(P<0.05); Compared with the relative expression quantity24hours post-operation, that30days post-operation decreases and the difference has a statistical significance(P<0.05); Compared with the relative expression quantity pre-operation, that30days post-operation decreases, but the difference has no statistical significance (P>0.05)4. Before operation, there is a correlation between CK19and lymph node metastasis as well as muscularis invasion(P<0.05), while no correlation between CK19and pathological features of patients such as age, clinical stage (FIGO), differentiation degree of tumor cells, tumor size, pathological type;And no correlation between SCCAg and pathological features of patients (P>0.05)5. The positive rate of CK19and SCCAg genes were associated with high risk factors of the postoperative pathological.Conclusions:1. Before operation, there are statistical significant differences in the relative expression quantity of CK19and SCCAg genes in the peripheral blood among patients with early cervical cancer in the experimental group; Combining the measurement of CK19and SCCAg genes expression in the peripheral blood of patients with cervical cancer by qRT-PCR technique can improve the positive rate.2.Compared with the relative expression quantity of CK19and SCCAg genes pre-operation on cervical cancer patients receiving radical hysterectomy, that24hours post-operation increases. Compared with the relative expression quantity pre-operation, that30days post-operation decreases.3.There is a correlation between the positive rate of CK19and lymph node metastasis as well as muscularis invasion. And no correlation between the positive rate of SCCAg and pathological features of patients.4.The positive rate of CK19and SCCAg genes were associated with high risk factors of the postoperative pathological. Only according to the postoperative pathologic examination results to determine the postoperative supplementary treatment approach, there may be insufficient.