外周血γ-谷氨酰转移酶mRNA-H亚型与甲胎蛋白对原发性肝癌诊断及肝外转移意义的比较

Clinical impact of γ-glutamyl transpeptidase messenger RNA subtypes and α-fetal protein in peripheral blood on diagnosis and metastasis of hepatocellular carcinoma

目的 探讨外周血γ 谷氨酰转移酶 (GGT)mRNA H亚型及甲胎蛋白 (AFP)的表达与原发性肝癌 (HCC)诊断及肝外转移的关系。方法 以逆转录 聚合酶链反应方法检测HCC及对照组外周血GGTmRNA H亚型 ;运用放射免疫测定法检测外周血AFP水平。结果 65例肝癌中 ,GGTmRNA H亚型阳性率为 46.2 %。小肝癌AFP阳性率 (3 0 .0 % )明显低于大肝癌 (75 .6% ) ;其余各组AFP阳性率无差异 (P >0 .0 5 ) ;有肝内转移 (82 .1% )、门静脉癌栓 (86.4% )及远处转移组(90 .0 % )其外周血GGTmRNA H亚型阳性率显著高于无肝内转移 (18.9% )、门脉癌栓 (2 5 .6% )及远处转移组 (3 8.2 % ) (P <0 .0 5 )。血清AFP值的高低与肝癌患者外周血GGTmRNA H的阳性率两者差异无显著性 (P >0 .0 5 )。结论 检测HCC患者外周血细胞GGTmRNA H亚型表达对估计有无血行播散和远处转移有临床实用价值。对血清AFP值低或阴性患者进行周围血GGTmRNA

Objective To evaluate clinical impact of γ glutamyl transpeptidase messenger RNA (GGT?mRNA) subtypes and AFP in peripheral blood on diagnosis and metastasis of hepatocellular carcinoma.Methods The GGT、mRNA-H subtypes was detected by using RT PCR in HCC and diseased liver tissues without HCC from peripheral blood of all cases,meanwhile AFP was determined by RIA.Results GGT?mRNA in peripheral blood was positive in 30 out of 65 (46.2%),significantly more than those in tumor nonintra hepatistic metastasis group,non portal vein thrombosis group and non distant metastasis group.Conclusion Detecting GGT?mRNA H type in peripheral blood not only can reflect the hemotogenesis metastatic spreading of tumor cells in patients with HCC so as to predict the micrometatasis but also can play a supplementary role in the diagnosis of HCC with low level of serum AFP.