VEGF mRNA在预测肝癌肝移植术后肿瘤复发和转移中的应用价值

Prospective Evaluation of the Value of Vascular Endothelial Growth Factor Messenger RNA for Prediction of Recurrence and Metastasis of Hepatocellular Carcinoma Following Liver Transplantation

目的探讨血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)mRNA作为肝癌游离癌细胞标志物在预测肝癌肝移植术后复发和转移中的应用价值。方法以2002年4月至2003年12月期间的53例原发性肝癌肝移植患者为研究对象(肝癌肝移植组),通过建立稳定可靠的实时荧光定量RT-PCR检测方法来定量检测肝癌患者外周血中VEGFmRNA在整个肝移植术围手术期的动态变化情况,并与术后复发和转移进行相关分析;同时,为了解VEGFmRNA表达的特异性,分别设立了进展期肝癌组(n=8)、良性肝病组(n=26)和正常对照组(n=10)。结果VEGFmRNA可以作为肝癌游离癌细胞的标志物,具有较好的特异性。进展期肝癌组和肝癌肝移植组VEGFmRNA的表达阳性率明显高于良性肝病组和正常对照组(75.0%、37.7%vs11.5%、10.0%),P<0.01;术前VEGFmRNA的阳性表达和术后出现2次以上持续性的VEGFmRNA阳性表达与移植术后肝癌复发与转移相关(P<0.01)。结论术前检测VEGFmRNA阳性表达和术后持续的VEGFmRNA标志物检测表达阳性可以有效预测肝癌肝移植术后肿瘤复发和转移。

Objective To investigate the expression patterns of vascular endothelial growth factor （VEGF） mRNA as markers for isolated tumor cells in the peripheral blood of patients with hepatocellular carcinoma （HCC） following liver transplantation, and to evaluate the correlation between VEGF and the recurrence and metastasis of HCC following liver transplantation. Methods In this prospective study, 97 patient.s were divided into four groups according to the pathological results： HCC following liver transplantation group （ HCC2- LT group, n= 53）, ad-anced HCC group （n=8）, benign liver diseases group （n=26） and healthy volunteers group （n=10）, among which the 53 cases in HCC group were collected from April, 2002 to December, 2003. RNA was purified from the peripheral blood of the other 44 control patients and also from the patients in HCC group before, during and after liver transplantation in order to study the expression specificity of VEGF mRNA in HCC patients and its dynamic change during perioperative period. The correlation between VEGF and the tumor recurrence and metastasis was also analyzed by fluorescent quantitative reverse transcriptase and polymerase chain reaction （FQ RT PCR）. Results VEGF mRNA could be used as marker of isolated tumor cells for its high specificity. The positive rate of VEGF mRNA in HCC group and in advanced HCC group were 37.5% and 75.0% , respectively, which were significantly higher than that in benign liver diseases group （11. 5%） and healthy volunteers group （10.0%）, P〈0.01. The presence of preoperative VEGF mRNA and the consistent presence of postoperative VEGF mRNA might be relevant with the recurrence and metastasis HCC following liver transplantation （P〈 0. 01 ）. Conclusion The presence of preoperative VEGF mRNA and the consistent presence of postoperative VEGF mRNA may predict the recurrence and metastasis HCC following liver transplantation.