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目的探讨外周血甲胎蛋白(AFP)mRNA和外周血单核细胞(PBMC)端粒酶活性的检测在肝细胞癌(HCC)诊断中的意义。方法采用巢式逆转录PCR(Nest RT-PCR)法检测HCC、肝脏良性肿瘤、慢性肝病患者及正常人外周血的AFP mRNA表达,聚合酶链反应-酶联免疫吸附测定(PCR-ELISA)检测PBMC的端粒酶活性。结果 (1)AFP mRNA在HCC外周血中阳性率为73.3%(22/30),在肝脏良性肿瘤、慢性肝病患者及正常人外周血中无表达(分别为0/10,0/30,0/30),(均P<0.001)。(2)HCC患者PBMC端粒酶活性的阳性率(93.3%,28/30)显著高于肝脏良性肿瘤患者(40%,4/10)和慢性肝病患者(6.7%,2/30)及正常人(0),(分别P<0.01,<0.001,<0.001)。(3)外周血AFP mRNA与HCC PBMC的端粒酶活性表达呈显著正相关(r=0.6742,P<0.05)。结论 AFP mRNA是外周血HCC细胞的特异性标志物;端粒酶活性的检测具有更高的敏感性;两者的联合检测具有重要的临床意义。
Objective To investigate the significance of detection of AFP mRNA and telomerase activity in peripheral blood mononuclear cells (PBMC) in the diagnosis of hepatocellular carcinoma (HCC). Methods AFP mRNA expression was detected by nested-reverse-transcription polymerase chain reaction (RT-PCR) in peripheral blood of patients with HCC, benign liver tumors, chronic liver disease and normal controls. The expression of AFP mRNA was detected by polymerase chain reaction-enzyme-linked immunosorbent assay PBMC telomerase activity. Results (1) The positive rate of AFP mRNA in peripheral blood of HCC was 73.3% (22/30), there was no expression in peripheral blood of patients with benign liver tumors, chronic liver disease and normal persons (0/10, 0/30, 0 / 30), (all P <0.001). (2) The positive rate of telomerase activity in peripheral blood mononuclear cells (93.3%, 28/30) in patients with HCC was significantly higher than that in patients with benign liver tumors (40%, 4/10) and chronic liver disease (6.7%, 2/30) Human (0), (P <0.01, <0.001, <0.001, respectively). (3) There was a significant positive correlation between AFP mRNA in peripheral blood and telomerase activity in PBMC of HCC (r = 0.6742, P <0.05). Conclusion AFP mRNA is a specific marker of peripheral blood HCC cells. The detection of telomerase activity is more sensitive. The combined detection of these two markers has important clinical significance.