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目的 :寻找肝细胞癌微小转移的标志物。方法 :用巢式反转录聚合酶链反应 (Nested- RT- PCR)技术检测 6 5例肝细胞癌、2 1例非肝癌的恶性肿瘤、2 2例慢性乙型肝炎或肝硬化患者及 2 1例健康志愿者外周静脉血中的甲胎蛋白 (AFP) m RNA。结果 :AFP- m RNA在健康志愿者、非肝癌恶性肿瘤患者外周血中均为阴性 ;在肝细胞癌组外周血中 AFP- m RNA的检出率 (4 4/6 5 ,6 7.7% )明显高于慢性乙型肝炎或肝硬化组 (2 /2 2 ,9.1% ,P<0 .0 1)。AFP- m RNA检出率与临床分期、门静脉癌栓、肝外转移显著相关。在 12例血清 AFP<2 5 μg/L 的肝癌患者血中 ,7例 (5 8.3% )可检出 AFP- m RNA。结论 :AFP- m RNA可作为血循环中有肝癌细胞或肝细胞的标志物 ,在肝癌患者 ,阳性预示有血源性转移的可能 ;并且 AFP- m RNA对血清 AFP阴性或低值的肝癌患者能起到补充诊断作用
Objective: To find the markers of micrometastasis of hepatocellular carcinoma. Methods: Nested-RT-PCR was used to detect 65 hepatocellular carcinomas, 21 non-HCC malignant tumors, 22 chronic hepatitis B or cirrhosis patients and 2 One case of AFP m RNA in peripheral blood of healthy volunteers. Results: AFP-m RNA was negative in peripheral blood of healthy volunteers and non-HCC patients. The detection rate of AFP-m RNA in peripheral blood of HCC patients (44/65, 67.7%) Significantly higher than those in chronic hepatitis B or cirrhosis group (2/2 2, 9.1%, P <0.01). The detection rate of AFP-m RNA was significantly correlated with clinical stage, portal vein tumor thrombus and extrahepatic metastasis. AFP-m RNA was detected in 7 (5.33%) of 12 patients with hepatocellular carcinoma whose AFP was <25 μg / L. CONCLUSION: AFP-m RNA can be used as a marker of hepatic cancer cells or hepatocytes in the blood circulation. In patients with hepatocellular carcinoma, the positive expression of AFP-m RNA may indicate the possibility of blood-borne metastasis. AFP- Play a supplementary diagnostic role