摘要
目的肝细胞性肝癌（ＨＣＣ）预后差，唯有在ＨＣＣ转移前行手术切除才为其最佳的治疗选择，而用形态学方法找血中极其微量的ＨＣＣ细胞是非常困难的。为了更好确定周围血中ＨＣＣ细胞。方法采用逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）方法检测了２１例ＨＣＣ患者和２２例对照者的周围血白蛋白ｍＲＮＡ。结果发现晚期ＨＣＣ患者阳性率高，且与临床分期有关，有肺或门静脉累及者的阳性率较无肝外转移者高（Ｐ＝０．００３２）；血清甲胎蛋白（ＡＦＰ）＜２００μｇ／Ｌ和＞２００μｇ／Ｌ的ＨＣＣ患者阳性率之间差异无显著性（Ｐ＞０．０５）。结论该方法对ＨＣＣ早期微小转移有预示的可能，对ＨＣＣ患者预后的评估方面起一定的作用，尤其对血清ＡＦＰ阴性或低值的ＨＣＣ患者能起到补充诊断。
Objective The prognosis of hepatocellular carcinoma (HCC) is poor. The early resection of tumor before micrometastasis plays an important role in the treatment of HCC. However, it is very difficult to detect morphologically the malignant cells in peripheral blood, because the number of the malignant cells in the circulation is extremely small. For detecting the HCC cell. Methods A sensitive reverse transcriptase polymerase chain reaction (RT PCR) technique was used to detect the human albumin messenger RNA (mRNA) in the peripheral blood from 21 patients with HCC and 22 cases without HCC (7 cases of cirrhosis of the liver or chronic hepatitis, 3 cases of acute hepatitis, 2 cases of non HCC hepatic tumor and 10 normal volunteers or patients without liver diseases). Results In the patients with advanced stage HCC (TNM stages Ⅲ and Ⅳ), the albumin mRNA was found in 14 of 19 cases (74%). The positive rates of albumin mRNA in various stages of HCC were 0% (0 of 3) in stage Ⅱ、Ⅲ, 67%(8 of 12) in stage Ⅳ A, and 100%(6 of 6) in stage Ⅳ B. These results showed a strong correlation between the positive rate of albumin mRNA and the clinical stages. Furthermore, the positive rate of albumin mRNA was significantly higher (92%, 12 of 13) in the patients of HCC complicated with extrahepatic metastasis than those without (25%, 2 of 8), P =0.0032. There was no significant difference in the positive rate of albumin mRNA between the patients with high level (>200 μg/L) and low level (<200 μg/L) of serum α fetoprotein (AFP) (50%, 5 of 10 and 78%, 7 of 9, respectively), P >0.05. Except one with acute hepatitis, there were no positive result in the other 21 patients without HCC. Conclusion It is suggested that the presence of albumin mRNA in the peripheral blood may indicate the possibility of micrometastasis in patients with HCC. The detection of albumin mRNA is also useful in the prediction of the prognosis. Further, it may play a supplementary role in the diagnosis of HCC with low level of serum AFP.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1998年第1期10-13,共4页
Chinese Journal of Internal Medicine
基金
美国中华医学基金会(CMB)资助
关键词
MRNA
肝肿瘤
白蛋白
检测
Carcimoma, hepatocellular RNA, messenger
