联合检测外周血中AFPmRNA和AFP在原发性肝癌诊断中的临床意义

The clinical significance of AFPmRNA and AFP in the diagnoses of primary liver cancer

目的采用巢式RT-PCR法检测外周血中AFPmRNA情况。探讨外周血中AFPmRNA和AFP在原发性肝细胞癌(hepatocellular carcinoma,HCC)联合诊断及在高危人群普查中的作用,为HCC诊断及普查提供一种新的敏感、特异、简单快捷的方法。方法采用巢式RT-PCR法对25例HCC患者,慢性肝炎、急性肝炎、肝硬化、健康人各30例以及肝外恶性肿瘤10例的外周血AFPmRNA情况进行检测。同时检测各组相应的AFP浓度和HCC患者血清HBsAg表达情况。结果(1)外周血AFPmRNA检查:25例HCC患者中19例存在AFPmRNA,阳性率为76%,其余各组均未检出AFPmRNA,特异性100%;(2)血清AFP水平检测:25例HCC患者中有16例存在AFP阳性,阳性率64%,其余各组有5例检出AFP阳性。(3)HCC血清HBsAg检测:HBsAg阳性的16例HCC患者中15例检出AFPmRNA,而9例HBsAg阴性的HCC患者中仅4例检测出AFPmRNA。HBsAg与外周血中AFPmRNA阳性检出率有相关性。结论外周血AFPmR-NA联合血清AFP检测,可以有效提高HCC诊断,为联合检测诊断HCC提供了有效的途径;可以用于HCC高危人群的普查及筛选。

Objective The study was designed to detect AFPmRNA in peripheral blood for by Nested RT-PCR exploring the function of early diagnosis and distinguishing the high potential patients and providing a method for clinical diagnosis of HCC wtfich is sensitive, specific, simple and practical. Methods Nested RT-PCR was adopted to detect AFPmRNA in peripheral blood from 25 patients of HCC, 30 healthy people, and also 10 patients of malignant tumor outside liver. In addition, AFP concentration in serum of each group was detected,and HBsAg expression of HCC was examined.Results 1） Detecting AFPmRNA in peripheral bloed：The AFPm- RNA is positive in 19 blood samples among the 25 HCC cases, and it is negative in all the other groups. The specific of this experiment is 100% .2） Detecting serum AFP concentration：clinically significant elevated AFP （ 〉 20 ng/ml） were found in 64%（16/25） of HCCs.Totally 5 patients showed elevated AFP level in the other groups.3） Detecting serum HBsAg expression：a significant relationship was found between AFPmRNA and HBsAg （ P 〈 0.05）. Conclusion Detecting AFPmRNA and AFP,may enhance the HCC diagnosis effectively and provide a stable and specific method to diagnose and judge primary HCC. And it can also help to distinguish the high potential patients.