原发性肝癌患者外周血微转移检测的临床意义
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摘要
目的:建立检出原发性肝癌(PHC)患者外周血中微转移的方法,并探讨其临床意义。
方法:采集50例PHC患者,40例肝良性疾病(10例肝血管瘤,10例肝囊肿,10例肝硬化,10例慢性肝炎)患者,20例肝转移肿瘤患者(直肠癌肝转移10例,胃癌肝转移10例),30例健康志愿者的外周血。用RT-PCR方法检测外周血中AFPmRNA和CD44v6mRNA的表达。
结果:50例PHC患者外周血中AFPmRNA和CD44v6mRNA检出率分别为50%(25/50)和58%(29/50)。74%(37/50)的患者至少一种标志物阳性。AFPmRNA在肝炎肝硬化患者外周血中的检出率为15%(3/20),转移性肝癌、肝血管瘤、肝囊肿患者及健康献血员中均未检出。CD44v6mRNA在转移性肝癌患者外周血中的检出率为45%(9/20),肝炎肝硬化、肝血管瘤、肝囊肿患者及健康献血员中均未检出。PHC患者外周血中AFPmRNA检出率与血清AFP水平,肿瘤大小,门静脉癌栓,肝内转移无相关性(p>0.05)。与肝外转移密切相关(p<0.05)。CD44v6mRNA检出率与肿瘤大小,门静脉癌栓,肝内外转移密切相关(p<0.05),而与血清AFP水平无相关性(p>0.05)。
结论:在PHC患者外周血中联合检测AFPmRNA和CD44v6mRNA的表达,有助于提高微转移检测的灵敏度和特异性,CD44v6mRNA预测肝癌转移、
Objective: To establish the molecular method to detect peripheral blood micrometsastasis in patients with Primary hepatocellular carcinoma(PHC),and discuss its clinical sigificance.
Methods: A sensitive RT-PCR system was set up to detect AFPmRNA and CD44v6mRNA in the peripheral blood of 50 PHC patients, 10 hepatic hemangioma patients ,10 hepatic cyst patients,10 hepatocirrhosis patients,10 chronic hepatitis patients, 20 patients with metastatic liver cancer, and 30 healthy volunteers.
Results: Of the PHC patients, expression of AFPmRNA and CD44v6mRNA was positive respectively in 50%(25/60) and 58%(29/50) of the peripheral bloods.while 37(74% )PHC patients were positive for at least 1 marker. With regard to controls, 3 of 20 samples(15%)from group hepatitis and cirrhosis showed AFPmRNA,but none of samples from other control group showed AFPmRNA. And 9 of 20(45%)samples from patients with metastatic liver cancer showed CD44v6mRNA in their peripheral blood,but groups of hepatitis and cirhosis,hepatic hemangioma,hepatic
方法:采集50例PHC患者,40例肝良性疾病(10例肝血管瘤,10例肝囊肿,10例肝硬化,10例慢性肝炎)患者,20例肝转移肿瘤患者(直肠癌肝转移10例,胃癌肝转移10例),30例健康志愿者的外周血。用RT-PCR方法检测外周血中AFPmRNA和CD44v6mRNA的表达。
结果:50例PHC患者外周血中AFPmRNA和CD44v6mRNA检出率分别为50%(25/50)和58%(29/50)。74%(37/50)的患者至少一种标志物阳性。AFPmRNA在肝炎肝硬化患者外周血中的检出率为15%(3/20),转移性肝癌、肝血管瘤、肝囊肿患者及健康献血员中均未检出。CD44v6mRNA在转移性肝癌患者外周血中的检出率为45%(9/20),肝炎肝硬化、肝血管瘤、肝囊肿患者及健康献血员中均未检出。PHC患者外周血中AFPmRNA检出率与血清AFP水平,肿瘤大小,门静脉癌栓,肝内转移无相关性(p>0.05)。与肝外转移密切相关(p<0.05)。CD44v6mRNA检出率与肿瘤大小,门静脉癌栓,肝内外转移密切相关(p<0.05),而与血清AFP水平无相关性(p>0.05)。
结论:在PHC患者外周血中联合检测AFPmRNA和CD44v6mRNA的表达,有助于提高微转移检测的灵敏度和特异性,CD44v6mRNA预测肝癌转移、
Objective: To establish the molecular method to detect peripheral blood micrometsastasis in patients with Primary hepatocellular carcinoma(PHC),and discuss its clinical sigificance.
Methods: A sensitive RT-PCR system was set up to detect AFPmRNA and CD44v6mRNA in the peripheral blood of 50 PHC patients, 10 hepatic hemangioma patients ,10 hepatic cyst patients,10 hepatocirrhosis patients,10 chronic hepatitis patients, 20 patients with metastatic liver cancer, and 30 healthy volunteers.
Results: Of the PHC patients, expression of AFPmRNA and CD44v6mRNA was positive respectively in 50%(25/60) and 58%(29/50) of the peripheral bloods.while 37(74% )PHC patients were positive for at least 1 marker. With regard to controls, 3 of 20 samples(15%)from group hepatitis and cirrhosis showed AFPmRNA,but none of samples from other control group showed AFPmRNA. And 9 of 20(45%)samples from patients with metastatic liver cancer showed CD44v6mRNA in their peripheral blood,but groups of hepatitis and cirhosis,hepatic hemangioma,hepatic
引文
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[27] 金成兵, 伍烽, 王智彪,等. 高强度聚焦超声治疗前后肝癌患者外周血AFPmRNA 的变化[J].中国超声医学杂志,2003.11.16; 19(11): 838-841.
[2] Ghossein RA,Osman I, Bhattacharya S, et al. Detection of prostatic specific membrane antigen messenger RNA using immunobead reverse transcriptase polymerase chain reaction[J]. Diagn Mol Pathol,1999,8:59-65.
[3] 黄东胜,傅佩芬,郑树森,等. 肝癌病人外周血及骨髓 AFP mRNA 的检测及意义[J].中华肝胆外科杂志,2002.03.28; 8(3): 154-158.
[4] 彭安邦,石巍,胡四海,等. CD44v6 在胃癌中的表达及其与幽门螺杆菌感染的关系[J]。癌症杂志,2003,22(11):1184-1187.
[5] Mutsuko M,Naoshi N, et al.Postoperative detection of a-fetoprotein mRNA in blood as a predictor for metastatic recurrence of hepatocellular carcinoma[J]. Gastroenterol Hepatol,2001,16(4):445-451.
[6] Miyamoto,-A; Fujiwara,-Y; Sakon,-M;et al. Development of a multiple-marker RT-PCR assay for detection of micrometastases of hepatocellular carcinoma[J]. Dig-Dis-Sci. 2000 Jul; 45(7): 1376-82
[7] Kedda MA, Kew MC, Skelton M, et al. Nonspecific messenger RNA of a-fetoprotein in peripheral blood in detecting early spread of hepatocellular carcinoma in black Africans[J]. Gastroenterol Hepatol,1998,13(6):885-891.
[8] Rui JA,Wang SB,Chen SG,et a1.Serial Therapies Oriented by Surgery for Large Primary Liver Carcinoma [J].Hepatobiliary Pancreat Dis Int,2002,1(3):411-415.
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