摘要
目的探讨RNADNA含量及细胞增殖指数(PI)在原发性肝细胞癌(PHC)中的应用价值.方法应用流式细胞分析技术,对64例(男46例,女18例,年龄24岁~70岁,平均515岁)PHC细胞RNA,DNA含量及PI进行了定量分析,并对患者进行了1年~55年的随访.结果RNA和DNA指标对PHC的诊断符合率分别为937%和750%,双指标联合应用诊断符合率为968%,RNA指标更敏感.RNA和DNA含量与预后关系密切.DNA含量随组织学分级的增高而增加(Ⅰ级为125,Ⅱ级为140,Ⅲ级为151,Ⅳ级为168),组织学各级之间DNA含量均有显著性差异(P<005),提示DNA含量可作为组织学分级的定量指标.DNA倍体与年龄(<50岁,829%vs≥50岁,609%;P<005)、HCV感染(812%vs563%,P<005)密切相关,与性别、AFP水平、HBsAg及瘤体大小无关.PI值显著高于正常对照组(038±012vs010±004,P<001),PI>040者预后差.结论RNA,DNA含量及PI值可作为PHC的诊断及判断预后的指标,RNA及DNA双指标联合应用价值更?
AIM To study the clinical significance of RNA and DNA contents and PI in patients with primary hepatocellular carcinoma (PHC). METHODS The cellular RNA and DNA contents and PI in 64 patients (46 males, 18 females) aged from 24 to 70 years with PHC were analysed by flow cytometry. All patients were followed up for 1~5 5 years. RESULTS The diagnostic accuracy rates of RNA index (RI) and DNA index (DI) were 93 7% and 75 0% in PHC respectively, and accuracy rate of combined RI and DI was 96 8%. Statistically the RI was significantly more sensitive than DI ( P <0 05). The incidence of aneuploid PHC was higher in patients under 50 years of age (82 9% vs 60 9%, P <0 05) and in those with infection of HCV (82 1% vs 56 3%, P <0 05). However, there was no significant correlation between DNA ploidy and patient′s sex, serum AFP level, HBsAg or tumor size (5cm as threshold). PI was much higher in PHC as compared to the normal control group (0 38±0 12 vs 0 10±0 04, P <0 01), and PHC with PI over 0 40 showed poor prognosis. The DI was correlated with the histologic grading (grade Ⅰ DI=1 25, grade Ⅱ DI=1 40, grade Ⅲ DI=1 51, grade Ⅳ DI=1 68). CONCLUSION Cellular DI may be an objective and precise quantitative marker in judging the degree, grade and differention of PHC. The combination of RI and PI may be more important for indicating the biological nature of PHC.
关键词
肝癌
RNA
DNA
增殖指数
Liver neoplasms/metabolism\ \ RNA, neoplasm/analysis\ \ DNA, neoplasm/analysis