甲胎蛋白信使核糖核酸(AFPmRNA)的检测方法及其临床意义

The Method and the Clinical Significance of Detecting AFPmRNA

目的 探讨AFPmRNA对诊断原发性肝癌的意义 ,并评估原发性肝癌的临床分期 ,预测转移倾向、预后和复发以及治疗。方法 建立并改进巢式逆转录多聚酶链反应 (nestedRT -PCR)检测外周静脉血肝癌细胞。结果 nestedRT -PCR在 1ml血中含有≥ 5个肝癌细胞时即可检测到AFPmRNA。 2 2例原发性肝癌中 18例血液标本检测到AFPmRNA ,而对照组中均未检测到AFPmRNA。AFPmRNA的检出率与肝癌分期 (TNM )、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联系 (P <0 .0 1)。结论 nestedRT -PCR是一个稳定而又敏感的检测方法 ,AFPmRNA可作为定性诊断原发性肝癌的血液学指标 ,也可作为肝癌细胞转移的标志 ,并可判断肝癌临床分期、转移倾向。

Objective To research the clinical significance of AFPmRNA for diagnosing primary hepatocellular carcinoma,and to evaluate the clinical stages of primary hepatocellular carcinoma,to prognosticate metastases,prognosis,recurrence and to select the methods of therapy.Methods To establish and improve the method of nested retrotanscript polymerase chain reaction (RT-PCR) for detecting hepatic cancer cells in prepheral venous blood.Results The AFPmRNA can be detected in 1ml blood with five or more than five hepatic cancer cells using nested RT-PCR.The AFPmRNA is positive in 18 blood samples out of 22 cases,whereas it is negative in all control groups.The positive rate of AFPmRNA has a significant relationship with the hepatic cancer stages (TNM),the value of AFP in blood,intrahepatic metastases,the portal vein cancer cell thrombosis,the tumor size and the extrahepatic metastases ( P <0.01).Conclusion Nested RT-PCR is a stable and a sensitive detecting method,AFPmRNA can be not only a hemologic sign of diagnosing primary hepatic cancer,but also a mark of the metastases,and can be using for eveluating the clinical stages,metastases trend,prognosis and recurrence of liver cancer.