摘要
目的寻找一种敏感的用于早期发现原发性肝癌患者术后复发与转移的检测方法。方法应用巢式逆转录聚合酶链反应(nested RT-PCR)分别在术前、术后1周和术后两个月检测85例行根治性切除的原发性肝癌患者外周血中MAGE-1 mRNA和AFP mRNA的表达。结果外周血中MAGE-1 mRNA和(或)AFP mRNA的阳性率与肿瘤的病理分期呈正相关:肿瘤病期越晚,外周血中微转移灶的检出率越高(P<0.01)。1年的随访中,有23例患者出现复发,MAGE-1和(或)AFP mRNA的阳性率为78.3%(18/23),而62例无复发患者阳性率为46.8%(29/62),二者比较差异有显著性(P<0.01)。复发患者中,15例外周血中MAGE-1 mRNA和(或)AFP mRNA持续阳性,5例术前阴性者分别于术后5个月及8个月转为阳性,另外3例术前、术后均保持阴性。经术后1年随访,无肿瘤复发的62例患者中有24例MAGE-1 mRNA和(或)AFP mRNA由术前阳性转为术后阴性。AFP mRNA阳性率与血浆AFP水平呈正相关(P<0.01),MAGE-1 mRNA阳性率与血浆AFP水平无相关性(P>0.05)。外周血AFP mRNA和MAGE-1 mRNA阳性率与肿瘤直径均无相关性(P>0.05)。结论联合检测外周血MAGE-1和AFP mRNA的表达是早期发现肝癌术后复发、评估预后的一项敏感可信的指标。
Objective To find a sensitive method to detect the recurrence and metastasis of hepatocellular carcinoma in the early stage.Methods Tumour-specific MAGE-1 and AFP transcripts in the peripheral blood of HCC patients at three time points were tested by nested RT-PCR to detect the circulating tumour cells and evaluate their potential clinical implication. Results Detection of MAGE-1 and/or AFP mRNA in peripheral blood was closely correlated to the pathological stages of HCC. The mere advanced stages of HCC, the higher rate of micrometastasis of cancer cells detectable in peripheral blood. In one year follow-up, 23 of 85 HCC patients showed recurrence, in whom the positive rate of MAGE-1 and/or AFP mRNA was 78.3% （ 18 out of 23）. Fiften of 23 had persistent expression of MAGE-1 mRNA and/or AFP mRNA in peripheral blood and 5 had MAGE-1 mRNA or AFPmRNA turned from negative to positive. In contrast, 24 patients with MAGE-1 and/or AFP transcripts positive before tumor resection and negative conversion after surgical treatment had no recurrence. Condusion Combination of detection of MAGE-1 and AFP mRNA in peripheral blood is a sensitive and valuable assay for the early prediction of the relapse and prognosis of the HCC patients.
出处
《中国肿瘤临床与康复》
2005年第4期297-300,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
