外周血有核细胞胰岛素样生长因子 ⅡmRNA检测对肝癌的诊断价值

Test of insulin-like growth factor Ⅱgene in peripheral blood and its clinical significance on hepatocellular carcinoma

目的 :分析肝癌患者外周血有核细胞中胰岛素样生长因子 (IGF - )基因片段 ,观察它在肝癌诊断和判断预后中的临床价值。方法 :从肝病患者外周血中制备有核细胞总 RNA,经随机引物和逆转录酶合成 IGF- -c DNA,分别以巢式聚合酶链反应扩增 IGF- 基因片段 ,分析肝病患者外周血中 IGF- 基因标志物检测的临床价值。结果 :(1)肝癌患者外周血中 IGF- 的检出率为 3 4.2 % ,明显高于其它肝病、肝外肿瘤和正常对照组 (P<0 .0 5 )。在 、 和 期肝癌中 ,IGF- 基因片段阳性率分别为 14 .3 %、19.4%和 45 .5 % ;(2 ) IGF- 基因片段的检出率在肝内有无转移的肝癌组间存在明显差异 (P<0 .0 5 ) ,伴有肝外远处转移肝癌中 ,IGF- 基因片段阳性率为 10 0 %。结论 :外周血中 IGF- 基因标志物有助于肝癌的诊断、肝癌远处转移的判断以及肝癌术后复发的监测。

Objective:The insulin-like growth factor Ⅱgene in peripheral blood mononuclear cells in patients with primary hepatocellular carcinoma (PHCC) was amplified by using molecular biologicalassays to explore its clinical value in diagnosis and judgement of prognosis of HCC.Methods:Total RNAs were extracted from peripheral blood mononuclear cells in patients with liver diseases. The IGF-Ⅱ-mRNAs were synthesized to cDNA through random primers and reverse transcriptase, the IGF-Ⅱ-DNAs were amplified by nested reverse transcription polymerase chain reaction (RT-PCR), the clinical value of IGF-Ⅱgene marker was assessed in patients with liver disease.Results:(1) The positive rate of peripheral blood gene fragments in patients with HCC was 34.2% ,significantly higher than that in liver cirrhosis (LC), chronic hepatitis(CH), acute hepatitis(AH) and extrahepatic tumor (ET).Withstage Ⅰ、 stage Ⅱ and stage Ⅲ HCC ,the positive rate of IGF-Ⅱ-mRNA was 14.3%、19.4% and 45.5% respectively。(2) The incidence of IGF-Ⅱ-mRNA was correlated with the stage of HCC and the intrahepatic metastasis. IGF-Ⅱ-mRNA was found in all metastasis at extrahepatic organs (100%).Conclusions:The present date suggest that IGF-Ⅱ gene fragment analysis of peripheral blood by using molecular biological assays be a useful marker for HCC diagnosis、judgement of extrahepatic metastasis and monitoring postoperation recurrence.