摘要
目的 检测结直肠癌术中腹腔灌洗液悬浮细胞中CDH1基因甲基化状态并探讨其与结直肠癌临床病理资料及预后的关系.方法 前瞻性纳入2011年10月至2013年10月间中山市中医院手术治疗的原发性结直肠癌患者.采用实时荧光甲基化特异性聚合酶链反应技术,检测术中腹腔灌洗液悬浮细胞中CDH1基因启动子区域5＇-CpG岛的甲基化状态,将甲基化百分率大于20％定义为甲基化,小于或等于20％为非甲基化;分析CDH1基因甲基化状态与结直肠癌临床病理特征及预后的关系.结果 共102例患者纳入研究,其中CDH1甲基化组47例,非甲基化组55例.与非甲基化组比较,甲基化组患者肿瘤直径更大,浸润型比例更高,分化程度更低,淋巴结转移和远处转移率更高,临床分期更晚（均P＜0.05）.甲基化组患者中位生存期短于非甲基化组（26.0月比41.4月,P＜0.05）.Cox模型分析显示,CDH1甲基化状态是结直肠癌患者术后生存的独立危险因素（RR=27.5,95％CI：3.8～51.3,P＜0.01].结论 术中腹腔灌洗液悬浮细胞中CDH1基因发生甲基化的结直肠癌患者恶性程度较高,易发生淋巴结转移和远处转移,预后较差。
Objective To detect the CDH1 gene methylation of suspension cells in intraoperative abdominal lavage fluid from colorectal cancer patients,and to examine its association with clinicopathology and prognosis.Methods Real-time methylation-specific polymerase chain reaction （qMSP） was used to investigate the methylation status of the CDH 1 gene promoter 5＇-CpG islands from intraoperative abdominal lavage fluid in 102 patients with colorectal cancer.The associations between methylation of CDH1 genes and clinicopathologic features and prognosis were investigated.Results Among the 102 colorectal cancer patients,aberrant methylation of CDH1 gene was detected in 47 patients.Significant associations were found between CDH1 methylation status and tumor size,growth pattern,differentiation,distant metastasis,and clinical staging （all P〈0.05）.The median progression-free survival was 25.98 months for CDH1 methylation group and 41.36 months for non-methylated group,and the difference was statistically significant（P〈0.01）.Cox model analysis revealed that CDH1 methylation status in intraoperative peritoneal lavage fluid was an independent factor associated with postoperative survival in colorectal cancer patients （50.23% vs.86.51%,P=0.001）.Conclusions Colorectal cancer patients with aberrant methylation of 5＇-CpG of CDH1 gene promoter of suspension cells in abdominal lavage have higher malignancy,more metastasis and worse prognosis.
出处
《中华胃肠外科杂志》
CAS
CSCD
2014年第11期1133-1136,共4页
Chinese Journal of Gastrointestinal Surgery
基金
广东省中山市科技计划项目（20132A189）
