小肝癌患者外周血中SSX基因mRNA的检测和临床意义

Detection of the expression of SSX gene mRNA as tumor markers of circulating hepatocellular carcinoma cells in patients with small HCC

目的检测小肝细胞癌(HCC)患者外周血中SSX基因mRNA的表达,并初步探讨其临床意义。方法以简易“降落”PCR(stepdownRT_PCR)方法检测小HCC患者外周血中SSX基因mRNA表达,并将SSX基因的表达与预后等临床指标的关系进行分析。结果79.5%(31/39)的小肝癌患者肝癌组织中存在SSX基因mRNA的表达,而癌旁组织、肝硬化组织和正常肝组织均为阴性。外周血标本中,28.2%(11/39)的病例可检测到SSX基因的表达。癌组织不表达SSX基因者和对照组,外周血中也不能检测到其表达。小HCC患者外周血中SSX基因的表达与年龄、性别、肿瘤分化程度、血清AFP水平和HBV感染无显著相关性。随访16.7±5.1月,在11例外周血中表达SSX基因mRNA的患者中6例出现了复发和(或)转移,而20例阴性的患者仅有3例出现了复发和(或)转移,二者相比有显著差异(P=0.038),提示外周血中SSX基因表达与复发、转移密切相关。结论SSX基因可作为小HCC患者循环肝癌细胞的标志基因,并能反映预后。

Objective To detect the SSX gene mRNA, as tumor marker of the circulating hepatocellular carcinoma （HCC） cells, in peripheral blood from patients with small HCC and to investigate its potential clinical implication. Methods The expression of SSX mRNA was detected using RT - PCR （steptown PCR） in peripheral blood mononuclear cells （PBMC） from 39 patients with small HCC and 30 healthy volunteers. The relationships between the presence of SSX mRNA in PBMC of patients with small HCC and clinical data as well as prognosis were analyzed. Results SSX gene transcript were detectable in 79.5 % （31/39） of HCC samples, while no expression of SSX gene could be detectable in the corresponding adjacent NonHCC tissues, samples of cirrhosis and normal liver tissues. 28.2% （11 out of 39） of PBMC samples had expression of SSX gene transcripts. In the patients whose tumors did not express SSX gene transcripts, the corresponding SSX gene transcripts was also undetectable in their PBMC. There was no expression of SSX genes in the PBMC from the 30 healthy control, either. No relationship was found between the expression of SSX genes in the PBMC and clinical indicators such as age, sex, degree of tumor differentiation, serum α-fetoprotein level and infection of hepatitis B virus or hepatitis C virus（ P 〉 0.05）. After 16.7 ± 5.1 months＇follow-up, metastasis and/or recurrence were observed in 54.5 % （6 out of 11 ）patients with positive expression of SSX genes in their PBMC, while only 15.0% （3 out of 20） patients with out expression of SSX genes in their PBMC developed metastasis and/or recurrence （ P = 0.038）. Conclusion The present study confirms that SSX genes mRNA may be used as specific tumor markers for the detection of the circulating HCC cells. The positive expression of SSX genes in the PBMC had close correlation with prognosis of patients with small HCC.