目的:探讨色素内镜联合肿瘤标志物检测对早期结直肠癌诊断的意义.方法:选择Duck's分期 A、B期结直肠肿瘤病人30例为观察组;30例结直肠息肉经镜下切除病人作为对照组.用逆转录-聚合酶链式反应和Western blotting检测肿瘤组织癌胚抗原、Survivin在基因水平和蛋白水平的表达.结果:观察组30例病人中,黏膜内腺癌者8例,腺癌者22例,术后Duck' s分期A期12例,Duck's分期B期18例.癌胚抗原在Duck's分期A期和B期病人中的表达率分别为25.00%和27.78%, Survivin在Duck's分期A期和B期病人中的表达率分别为41.67%和55.56%.对照组30例良性肿瘤性息肉者,管状腺瘤22例,绒毛状腺瘤6例,管状绒毛状腺瘤2例,癌胚抗原、Survivin均未表达,表达率均低于观察组(P<0.05~P<0.01).此外,观察组内Survivin表达率显著高于癌胚抗原(P<0.01).结论:Survivin在早期结直肠癌组织中高表达,可作为联合色素内镜诊断结直肠癌的标志物,对结直肠癌早期诊断与治疗具有重大意义.%Objective:To investigate the clinical effects of stain endoscope combined with tumor biomarker in early diagnosis of colorectal cancer.Methods:According to Duck's staging,30 patients with stage Duck's A and B colorectal cancer were set as the observation group,and 30 colorectal polyp patients were set as the control group.The gene and protein expressions of carcinoembryonic antigen and Survivin in two groups were detected using RT-PCR and Western blotting,respectively.Results:Among 30 colorectal cancer patients,intramucosal adenocarcinom in 8 cases and adenocarcinoma in 22 cases were found,and stage Duck's A in 12 cases and stage Duck's B in 18 cases were identified after operation.The expression rates of carcinoembryonic antigen and Survivin at stage Duck's A were 25.00% and 27.78%,and the expression rates of carcinoembryonic antigen and Survivin at stage Duck's B were 41.67% and 55.56 %.Among 30 polyp patients,canalicular adenoma in 22 cases,villous adenoma in 6 cases and tubulovillous adenoma in 2 cases were found.The expressions of carcinoembryonic antigen and Survivin in control group were not found,which was lower than that in observed group(P<0.05 to P <0. 01). The expression rate of Survivin in observed group was significantly higher than that of carcinoembryonic antigen(P<0.01).Conclusions:The Survivin expression is high in early stage of colorectal cancer,which can set as a potential biomarker in combing with stain endoscope,and has important significance in the early diagnosis and treatment of colorectal cancer.
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