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目的：探讨肝细胞癌患者血液甲胎蛋白（ＡＦＰ）ｍＲＮＡ检测的临床意义。方法：取９３例肝癌患者、１５例肝炎后肝硬化患者、１２例慢性肝炎患者及１０例健康人静脉血各５ｍｌ，应用巢式ＲＴ－ＰＣＲ检测其周围静脉血中ＡＦＰｍＲＮＡ。结果：在５０个肝癌血标本中检测到ＡＦＰｍＲＮＡ（５３．８％），而对照组中未检测到１例。ＡＦＰｍＲＮＡ检出率与肝癌分期、血清ＡＦＰ浓度、肝内转移、门静脉癌栓、肿瘤大小及远处转移有明显相关（Ｐ＜０．０５）。２１例伴有肝外远处转移的原发性肝癌血标本均被检测到ＡＦＰｍＲＮＡ（１００％），没有远处转移的７２例肝癌血标本中有２９例检测到ＡＦＰｍＲＮＡ（４０．３％）。结论：ＡＦＰｍＲＮＡ可以作为肝癌细胞血液转移的标志，也可作为肝癌远处转移的预测性指标之一
Objective: To explore the clinical significance of blood alpha-fetoprotein (AFP) mRNA detection in patients with hepatocellular carcinoma. METHODS: AFP mRNA was detected by nested RT-PCR in 93 cases of hepatocellular carcinoma, 15 cases of posthepatitic cirrhosis, 12 cases of chronic hepatitis and 10 cases of healthy human venous blood. RESULTS: AFP mRNA was detected in 50 hepatoma specimens (53.8%), but not in the control group. The detection rate of AFPmRNA was significantly associated with liver cancer staging, serum AFP concentration, intrahepatic metastasis, portal vein tumor thrombus, tumor size and distant metastasis (P<0.05). Twenty-one cases of hepatocellular carcinoma with extrahepatic distant metastasis were detected with AFPmRNA (100%), and 72 cases with distant metastasis were detected with 29 cases of AFPmRNA (40.3%). Conclusion: AFP mRNA can be used as a marker of hepatoma cell metastasis, and it can also be used as one of the predictive markers for distant metastasis of hepatocellular carcinoma.