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目的检测胃癌患者门静脉血中p53和K-ras基因突变,探讨其与胃癌肝转移的关系。方法应用PCR-SSCP技术检测62例胃癌手术患者门静脉血中p53和K-ras基因的突变率。结果外周血和门静脉血中的p53和K-ras突变阳性率分别为8％、5％和39％、34％;有无肝转移p53和K-ras突变阳性率分别为92％、77％和24％、22％;剖腹后探查前或胃癌探查后门静脉血p53和K-ras突变阳性率分别为39%、34％和56％、63％,上述两组指标之间相比差异均有统计学意义(P< 0．05),但与患者性别、年龄、肿瘤的分化程度之间无显著性相关(P>0．05)。结论门静脉血内微转移癌细胞的基因突变检测有助于判断胃癌临床分期,对预测胃癌肝内微小转移有一定的临床价值。
Objective To detect the mutations of p53 and K-ras in portal vein blood of gastric cancer patients and explore the relationship between them and hepatic metastasis of gastric cancer. Methods The mutation rates of p53 and K-ras genes in portal vein blood of 62 patients with gastric cancer were detected by PCR-SSCP. Results The positive rates of p53 and K-ras mutations in peripheral blood and portal vein blood were 8%, 5%, 39% and 34%, respectively; the positive rates of p53 and K-ras mutations were 92% and 77% in liver metastases, respectively. The positive rates of p53 and K-ras mutations in portal vein blood before or after exploratory laparotomy were 39%, 34%, 56%, and 63%, respectively. The differences between the two groups were statistically significant. Significance (P < 0.05), but no significant correlation with gender, age, tumor differentiation (P> 0.05). Conclusion The detection of gene mutations in portal vein blood micrometastasis cancer cells is helpful to determine the clinical stage of gastric cancer and has certain clinical value in predicting the intrahepatic micrometastasis of gastric cancer.