肝癌特异性AFP及端粒酶活性联合分析对肝癌的诊断价值

Diagnostic Values of Combined Hepatoma-Specific α-Fetoprotein Fraction and Telomerase in Patients with Hepatocellular Carcinoma

目的:探讨外周血肝癌特异性甲胎蛋白(AFP-L3)及单个核细胞端粒酶在肝癌诊断和鉴别诊断中的临床价值。方法:从肝癌、肝硬化、慢性肝炎患者及健康献血者外周血单个核细胞中制备总RNA,以端粒重复扩增法-酶联免疫吸附试验(TRAP-ELISA)检测端粒酶的表达水平;并以小扁豆凝集素亲和层析法分离血清中AFP-L3,以放射免疫法测定AFP-L3与总AFP的比值(AFP-L3%),综合评价两标志物在肝癌中的表达与临床价值。结果:在肝癌、肝硬化、慢性肝炎及健康献血者中,外周血单个核细胞中端粒酶阳性率分别为74.5%、16.4%、10.0%和0;血清AFP-L3%阳性率分别为90.9%、20.0%、7.5%和0,两者联合分析对肝癌诊断的阳性率为94.5%。肝癌患者端粒酶及AFP-L3%阳性率明显高于其他各组(P<0.01)。肝癌患者手术后两指标明显下降,但术后伴有远处转移及复发者的AFP-L3%及端粒酶又明显升高。结论:外周血端粒酶及AFP-L3%分析有助于肝癌诊断、鉴别诊断和转移复发监测。

Objective：To explore the diagnostic values of combined hepatoma -specific alpha -fetoprotein fraction（AFP-L3） and telomerase in patients with hepatocellular carcinoma（HCC）.Methods：Total RNAs were extracted from circu-lating blood of patients.The cDNA were synthesized by random primer method.The telomerase activities of peripheral blood mononuclear cells（PBMCs）were analyzed by TRAP-ELISA.AFP-L3 was separated by lectin-affinity chromatography and both of AFP and AFP-L3 were detected by radioimmunoassay（RIA）.Results：Of patients with HCC,cirrhosis,chronic hep-atitis,and normal control group,the incidences of AFP-L3 were 90.9%,20%,7.5% and 0,and telomerase positive rates were 74.5%,16.4%,10.0% and 0,respectively.The incidence of AFP-L3% or telomerase in HCC group were significantly higher than those in cirrhosis,chronic hepatitis and normal control groups（P 〈 0.01）.No significant relationship was found a-mong AFP-L3%,telomerase and total AFP,except of HCC metastasis and relapse.Conclusion：The analysis of AFP-L3% or telomerase is an useful marker to diagnose and differentiate HCC or monitor metastasis and relapse of HCC.